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Immunoadsorption therapy for paraneoplastic syndromes

T T Batchelor1, M Platten, F H Hochberg

  • 1Brain Tumor Center, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA. batchelor@helix.mgh.harvard.edu

Journal of Neuro-Oncology
|January 19, 1999
PubMed
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Protein A immunoadsorption shows promise for treating paraneoplastic neurologic syndromes, offering a potential new therapy for these challenging autoimmune conditions associated with cancer.

Area of Science:

  • Neurology
  • Immunology
  • Oncology

Background:

  • Paraneoplastic neurologic syndromes (PNS) are increasingly recognized complications of systemic cancer.
  • Current treatments like steroids and immunoglobulin therapy yield disappointing results for PNS.
  • These syndromes are believed to be immunologically mediated.

Purpose of the Study:

  • To evaluate the efficacy and safety of protein A immunoadsorption for treating paraneoplastic neurologic syndromes.
  • To establish an institutional, open-arm treatment protocol for protein A immunoadsorption in PNS patients.

Main Methods:

  • Protein A immunoadsorption was administered in 6 sessions, twice weekly.
  • Thirteen patients with various PNS (cerebellar degeneration, opsoclonus/myoclonus, encephalomyelitis, Lambert Eaton myasthenic syndrome) and associated cancers were treated.

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  • Clinical symptoms and signs were assessed to evaluate treatment response.

    • Main Results:

    • Twelve of 13 patients completed the therapy.
    • A 75% response rate was observed, with 3/12 patients achieving a complete response and 6/12 a partial response.
    • Toxicity was minimal, including cutaneous vasculitis in one patient and transient hemisensory changes in another.

    Conclusions:

    • Protein A immunoadsorption demonstrates potential as a promising therapy for paraneoplastic neurologic syndromes.
    • Despite the small sample size, this treatment warrants further investigation in larger patient cohorts.
    • Current treatments for PNS remain unsatisfactory, highlighting the need for novel therapeutic approaches.