title: Efficacy and safety of mitoxantrone in patients with highly relapsing neuromyelitis optica.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of mitoxantrone hydrochloride and determine how it exhibits a differential inhibitory effect on subsets of B cells in patients with highly relapsing neuromyelitis optica (NMO).
  
  
  METHODS
  Retrospective case series with prospective follow-up.
  
  
  METHODS
  Three referral medical centers in the Republic of Korea.
  
  
  METHODS
  Twenty patients with highly relapsing NMO or neuromyelitis optica spectrum disorder who had at least 2 relapses during the year preceding the start of mitoxantrone treatment, despite other immunotherapies.
  
  
  METHODS
  Infusions of mitoxantrone up to a maximum cumulative dose of 120 mg/m(2).
  
  
  METHODS
  Annualized relapse rate, disability according to the Expanded Disability Status Scale score, and fraction of CD27(+)CD19(+) memory B cells.
  
  
  RESULTS
  During mitoxantrone treatment, the median annualized relapse rate was reduced by 75%, and 50% of patients became relapse free. Disability improved or stabilized in all patients. No patients had serious adverse effects during the mean follow-up period of 41 months after completing therapy. Flow cytometric analysis of cell surface markers revealed that mitoxantrone treatment preferentially affected CD27(+)CD19(+) memory B cells.
  
  
  CONCLUSIONS
  Treatment with mitoxantrone in patients with highly relapsing NMO significantly reduces relapse rates, resulting in subsequent functional stabilization or improvement.
authors.affiliation: Department of Neurology, Research Institute and Hospital of National Cancer Center, Korea.
authors.forename: Su-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Woojun
authors.initials: W
authors.lastname: Kim
authors.forename: Min Su
authors.initials: MS
authors.lastname: Park
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Sohn
authors.forename: Xue Feng
authors.initials: XF
authors.lastname: Li
authors.forename: Ho Jin
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007970:Leukopenia / Q000139:chemically induced / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage* / Q000009:adverse effects*; D009325:Nausea / Q000139:chemically induced / Q000276:immunology; D009471:Neuromyelitis Optica / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D011446:Prospective Studies; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008942:Mitoxantrone