title: First use of alemtuzumab in Balo's concentric sclerosis: a case report.
abstract: Balo's concentric sclerosis (BCS) is a rare demyelinating disorder of the central nervous system. The humanised monoclonal antibody alemtuzumab has shown efficacy in another demyelinating disorder, relapsing-remitting multiple sclerosis. We aimed to explore its efficacy in treatment-refractory BCS. A 52-year-old male with radiologically confirmed progressive BCS resistant to steroids, plasmapharesis and cyclophosphamide was administered a standard protocol of alemtuzumab. Treatment failed to slow his decline; he died 6 months after administration. Why alemtuzumab induced no clinical or radiological impact may be multifactorial. We review the evidence directing BCS therapy and propose the next steps for exploring this potentially fatal condition.
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: J W L
authors.initials: JW
authors.lastname: Brown
authors.forename: A J
authors.initials: AJ
authors.lastname: Coles
authors.forename: J L
authors.initials: JL
authors.lastname: Jones
mesh_terms: D000074323:Alemtuzumab; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D004750:Enteral Nutrition; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy; D018908:Muscle Weakness / Q000209:etiology; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D011015:Pneumonia, Aspiration; D017211:Treatment Failure
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D018696:Neuroprotective Agents; D000074323:Alemtuzumab; D008775:Methylprednisolone
keywords: Balo’s concentric sclerosis; Campath®; alemtuzumab; treatment