High-dose cyclophosphamide without stem cell rescue for refractory multifocal motor neuropathy.
Patients with multifocal motor neuropathy (MMN) respond to intravenous immune globulin (IVIg) and cyclophosphamide, although the benefit is not sustained. High-dose cyclophosphamide can induce a remission in patients with autoimmune diseases, including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We describe a patient with refractory MMN who improved with high-dose cyclophosphamide (50 mg/kg for 4 days) without stem cell rescue. Following treatment she discontinued IVIg. At a 6-month examination, her strength had improved and she had regained the ability to write. High-dose cyclophosphamide may be a successful treatment for patients with MMN refractory to other therapies.
Brannagan
Thomas H
TH
Weill Medical College of Cornell University, Department of Neurology and Neuroscience, Peripheral Neuropathy Center, 635 Madison Avenue, Suite 400, New York, New York 10022, USA. THB2006@med.cornell.edu
Alaedini
Armin
A
Gladstone
Douglas E
DE
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004351:Drug Resistance; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000188:drug therapy* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D009504:Neutrophils / Q000502:physiology; D010525:Peripheral Nerves / Q000503:physiopathology
D000970:Antineoplastic Agents; D003520:Cyclophosphamide