title: Application of serum natalizumab levels during plasma exchange in MS patients with progressive multifocal leukoencephalopathy.
abstract: Progressive multifocal leukoencephalopathy (PML) is a severe complication of natalizumab treatment. Restoring immune function by plasmapheresis/immunoadsorption (PLEX/IA) is important for the outcome of PML. We report on four multiple sclerosis (MS) patients whom developed PML during natalizumab treatment, in whom we measured serum natalizumab concentrations before and during PLEX. Depending on the serum natalizumab concentration at the time of PML diagnosis, the number of PLEX treatments necessary to reach subtherapeutic serum natalizumab concentrations is variable. Measuring serum natalizumab concentrations before and during PLEX is helpful to determine the optimum number of PLEX treatments in individual MS patients with PML.
authors: VU University Medical Center, Amsterdam, The Netherlands a.vennegoor@vumc.nl.
authors: A
authors: A
authors: Vennegoor
authors: Landsteiner Laboratory, Sanquin Research, Amsterdam, The Netherlands.
authors: T
authors: T
authors: Rispens
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: B W
authors: BW
authors: Van Oosten
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: M P
authors: MP
authors: Wattjes
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: M J
authors: MJ
authors: Wondergem
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: C E
authors: CE
authors: Teunissen
authors: Landsteiner Laboratory, Sanquin Research, Amsterdam, The Netherlands.
authors: D
authors: D
authors: Van der Kleij
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: B M J
authors: BM
authors: Uitdehaag
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: C H
authors: CH
authors: Polman
authors: VU University Medical Center, Amsterdam, The Netherlands.
authors: J
authors: J
authors: Killestein
mesh_terms: D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000097:blood*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood / Q000188:drug therapy*; D000069442:Natalizumab / Q000009:adverse effects / Q000097:blood*; D010951:Plasma Exchange
chemical_list: D007155:Immunologic Factors; D000069442:Natalizumab
keywords: Adverse effects; case studies; immunoadsorption; multiple sclerosis; natalizumab; plasmapheresis; progressive multifocal leukoencephalopathy