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Hematologic modifications in natalizumab-treated multiple sclerosis patients: An 18-month longitudinal study
Claire Bridel1, Yan Beauverd1, Kaveh Samii1
1Department of Clinical Neurosciences (C.B., P.H.L.), Division of Neurology, Unit of Neuroimmunology and Multiple Sclerosis; Department of Hematology (Y.B., K.S.); and Department of Genetics and Laboratory Medicine (P.H.L.), Laboratory Medicine Service, University Hospital of Geneva, Switzerland.
Natalizumab treatment for relapsing-remitting multiple sclerosis causes significant blood cell count changes, including the appearance of hematopoietic precursors. These hematologic modifications were not linked to any malignancies.
Area of Science:
- Hematology
- Immunology
- Neurology
Background:
- Relapsing-remitting multiple sclerosis (RRMS) is a chronic autoimmune disease.
- Natalizumab is an effective disease-modifying therapy for RRMS.
Purpose of the Study:
- To monitor hematologic modifications in peripheral blood of RRMS patients treated with natalizumab.
- To assess the safety of natalizumab concerning hematologic changes.
Main Methods:
- A cohort of 44 RRMS patients received monthly natalizumab for 18 months.
- Peripheral blood samples were collected monthly for complete blood cell count analysis.
- Blood smears were analyzed for abnormal findings.
Main Results:
- White blood cell, lymphocyte, and eosinophil counts increased significantly post-treatment initiation and remained stable.
- Monocyte counts progressively increased during the 18-month treatment.
- Erythroblasts and neutrophil precursors emerged in peripheral blood after natalizumab initiation, persisting throughout the study without associated malignancy.
Conclusions:
- Chronic natalizumab treatment induces significant hematologic changes, including the emergence of hematopoietic precursors.
- These observed hematologic modifications were not associated with adverse events like myelodysplastic syndrome or acute leukemia.
