Natalizumab-Associated Primary Central Nervous System Lymphoma

Area of Science:

• Immunology
• Neurology
• Gastroenterology

Background:

• Natalizumab is an effective immunomodulator for relapsing-remitting multiple sclerosis and Crohn disease.
• Concerns exist regarding a potential association between natalizumab use and the development of primary central nervous system lymphoma (PCNSL).

Purpose of the Study:

• To conduct a comprehensive literature review on lymphoma development following natalizumab therapy.
• To report an additional case of PCNSL in a patient treated with natalizumab for Crohn disease.

Main Methods:

• A systematic qualitative review adhering to PRISMA guidelines was performed.
• Data synthesis included patient characteristics, treatment details, and PCNSL risk factors.
• A case report of PCNSL in a young woman treated with natalizumab for Crohn disease was included.

Main Results:

• Eight reports, including the presented case, document lymphoma development post-natalizumab therapy.
• The findings suggest a potential, though remote, association between natalizumab and PCNSL that requires further investigation.

Conclusions:

• The current evidence for a causal link between natalizumab and PCNSL is considered weak.
• Given natalizumab's therapeutic benefits, vigilant patient monitoring for PCNSL is advised.