Late-onset neutropenia after anti-CD20 therapy for multiple sclerosis, neuromyelitis optica spectrum disorders and MOG antibody-associated disease: A prospective study

• Published in: Revue neurologique Vol. 178; no. 3; pp. 253 - 255
• Main Authors: Rigal, J., Biotti, D., Lépine, Z., Ciron, J.
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-03-2022
• Subjects: Anti-CD20 monoclonal antibodies; Late-onset neutropenia; Multiple sclerosis; Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease; Neuromyelitis optica spectrum disorders (NMOSD); Anti-CD20 monoclonal antibodies; Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease; Multiple sclerosis; Neuromyelitis optica spectrum disorders (NMOSD); Late-onset neutropenia
• ISSN: 0035-3787
• DOI: 10.1016/j.neurol.2021.06.007

Late-onset neutropenia (LON) after anti-CD20 therapy is a poorly described side effect in inflammatory disorders of the CNS. In this prospective study, patients treated with Rituximab or Ocrelizumab for MS, neuromyelitis optica spectrum disorders or MOG antibody-associated disease (MOGAD) were asked to perform complete blood count (CBC) every two weeks for six months, with the aim of identifying LON. Out of 152 patients, two (1,32%) had an absolute neutrophil count <1,000/mm3: one patient with MOGAD had agranulocytosis and one patient with MS had grade 3 neutropenia. Both were asymptomatic. These results confirm that LON after anti-CD20 therapy in inflammatory disorders of the CNS is not exceptional. Nevertheless, this biological complication remains too infrequent to justify close systematic CBC follow-up.