IgM paraprotein‐associated peripheral neuropathy: small CD20‐positive B‐cell clones may predict a monoclonal gammopathy of neurological significance and rituximab responsiveness
| Autor: | Joshua Bomsztyk, Michael P. Lunn, Rajeev Gupta, Lucia Y. Chen, Evan Vitsaras, Stephen Keddie, Shirley D'Sa |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Paraproteinemias Plasma cell Pathogenesis 03 medical and health sciences 0302 clinical medicine immune system diseases hemic and lymphatic diseases medicine Humans Clinical significance Aged CD20 B-Lymphocytes biology business.industry Peripheral Nervous System Diseases Hematology Middle Aged Antigens CD20 medicine.disease Lymphoma Peripheral neuropathy medicine.anatomical_structure Immunoglobulin M 030220 oncology & carcinogenesis Immunology biology.protein Rituximab Bone marrow business Paraproteins 030215 immunology medicine.drug |
| Zdroj: | British Journal of Haematology. 188:511-515 |
| ISSN: | 1365-2141 0007-1048 |
| DOI: | 10.1111/bjh.16210 |
| Popis: | IgM paraprotein-associated peripheral neuropathy (PN) in patients without overt evidence of lymphoma is a recognised clinical entity of unknown aetiology. Interrogating the bone marrow B-cell or plasma cell clones underlying paraproteinemic neuropathies may improve our understanding of both pathogenesis and treatment options. This retrospective observational analysis of IgM paraprotein-associated PN identified five patients with small pathological MYD88 L265P and CD20-positive B-cell clones in their bone marrow using multi-parametric flow cytometry, who have shown durable neurological response to rituximab. We posit that multi-parametric flow cytometry may be instrumental in identifying the cellular source of the paraprotein in IgM paraprotein-associated PN, and thus directing appropriate immunomodulatory therapy. Further understanding of these small pathological B-cell clones may also provide additional insight into mechanisms of monoclonal gammopathy of clinical significance overall. |
| Databáze: | OpenAIRE |
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