Non-late-onset neutropaenia following treatment of multiple sclerosis with ocrelizumab

E M Alba Suárez; A Tallón Barranco; I Puertas Muñoz; B Chamorro Hernández; Á Robles Marhuenda

doi:10.1016/j.nrl.2021.01.010

Non-late-onset neutropaenia following treatment of multiple sclerosis with ocrelizumab

Neurologia (Engl Ed). 2021 Mar 13:S0213-4853(21)00026-8. doi: 10.1016/j.nrl.2021.01.010. Online ahead of print.

[Article in English, Spanish]

Authors

E M Alba Suárez¹, A Tallón Barranco², I Puertas Muñoz², B Chamorro Hernández², Á Robles Marhuenda³

Affiliations

¹ Servicio de Neurología Hospital Universitario La Paz, Spain. Electronic address: eldamaselda@gmail.com.
² Servicio de Neurología Hospital Universitario La Paz, Spain.
³ Servicio de Medicina Interna Hospital Universitario La Paz, Spain.

PMID: 33726971
DOI: 10.1016/j.nrl.2021.01.010

Abstract

Late-onset neutropaenia is defined as an absolute neutrophil count of <1.5×10³cells/μL starting>4 weeks after the last dose of rituximab, in the absence of other identifiable causes. Late-onset neutropaenia is a rare adverse reaction to rituximab (observed in approximately 5% of patients). Rheumatic diseases constitute the main indication for rituximab; in these patients, neutropaenia appears after a mean of>28 days. Ocrelizumab is another monoclonal antibody that binds to CD20 (a glycosylated phosphoprotein mainly expressed on the membranes of B-lymphocytes); in January 2018, it was approved for the treatment of relapsing-remitting and primary progressive multiple sclerosis. We present a case of neutropaenia following intravenous infusion of ocrelizumab in a patient with primary progressive multiple sclerosis who presented with neutropaenic fever, herpetic stomatitis, and ecthyma gangrenosum only 20 days after infusion.

Keywords: Esclerosis múltiple; Multiple sclerosis; Neutropaenia; Neutropenia; Ocrelizumab.