Ocular symptoms in children treated with human-mouse chimeric anti-GD2 mAb ch14.18 for neuroblastoma.
Unusual ocular symptoms observed during intravenous treatment with anti-disialoganglioside antibody (Ab) in children suffering from neuroblastoma were analyzed and the results reported. Within the framework of the German Collaborative Neuroblastoma Study NB97, 85 children with high-risk neuroblastoma received anti-GD2 monoclonal antibody ch14.18 intravenously. Side effects were regularly reported to the study center. Ocular symptoms were recorded in clinical detail, duration and development over time. Symptoms of a parasympathetic deficit corresponding to internal ophthalmoplegia, i.e. mydriasis and accommodation deficit, were found in 10 patients. They were uni- or bilateral, began after the termination of Ab infusion and improved or disappeared in all surviving children. They did not reappear or worsen upon repeated Ab infusions. The pathophysiology of these disorders remains poorly understood. It is concluded that during systemic treatment with the anti-GD2 antibody ch14.18, reversible symptoms of parasympathetic denervation of the eye may occur which, however, do not warrant termination of this treatment.
Kremens
Bernhard
B
Department of Pediatric Hematology-Oncology, Universitäts-Kinderklinik, University of Essen, Hufelandstr. 55, D-45122 Essen, Germany. bernhard.kremens@uni-essen.de
Hero
Barbara
B
Esser
Joachim
J
Weinel
Peter
P
Filger-Brillinger
Judith
J
Fleischhack
Gudrun
G
Graf
Norbert
N
Grüttner
Hans-Peter
HP
Niemeyer
Charlotte
C
Schulz
Ansgar
A
Wickmann
Lutz
L
Berthold
Frank
F
D000065:Accommodation, Ocular; D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D005732:Gangliosides / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D051379:Mice; D015878:Mydriasis / Q000209:etiology*; D009447:Neuroblastoma / Q000628:therapy*; D011993:Recombinant Fusion Proteins / Q000009:adverse effects*
D000911:Antibodies, Monoclonal; D005732:Gangliosides; D011993:Recombinant Fusion Proteins; C019403:ganglioside, GD2