Memory B Cells Predict Relapse in Rituximab-Treated Myasthenia Gravis

• Published in: Neurotherapeutics 2021-04, Vol.18 (2), p.938-948
• Main Authors: Ruetsch-Chelli, Caroline, Bresch, Saskia, Seitz-Polski, Barbara, Rosenthal, Alessandra, Desnuelle, Claude, Cohen, Mikael, Brglez, Vesna, Ticchioni, Michel, Lebrun-Frenay, Christine
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Immunological - pharmacology; Antineoplastic Agents, Immunological - therapeutic use; Biomedical and Life Sciences; Biomedicine; CD19 antigen; CD27 antigen; Child; Female; Flow cytometry; Flow Cytometry - methods; Humans; Immunological memory; Immunotherapy; Leukocytes; Lymphocytes B; Male; Memory B Cells - drug effects; Memory B Cells - metabolism; Memory cells; Middle Aged; Monoclonal antibodies; Myasthenia; Myasthenia gravis; Myasthenia Gravis - blood; Myasthenia Gravis - diagnosis; Myasthenia Gravis - drug therapy; Neoplasm Recurrence, Local - blood; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - drug therapy; Neurobiology; Neurology; Neuromuscular junctions; Neurosciences; Neurosurgery; Original; Original Article; Patients; Predictive Value of Tests; Prospective Studies; Rituximab; Rituximab - pharmacology; Rituximab - therapeutic use; Treatment Outcome; Young Adult
• ISSN: 1933-7213; 1878-7479; 1878-7479
• DOI: 10.1007/s13311-021-01006-9

Myasthenia gravis can be efficiently treated with rituximab but there is no consensus regarding administration and dose schedules in this indication. No marker has yet been described to predict the clinical relapse of patients. Our objective was to identify the B cell subpopulations predicting clinical relapse in patients suffering from generalized myasthenia gravis and treated with rituximab. Clinical and biological data of 34 patients followed between 2016 and 2019 were prospectively collected every 3 months. Using multiparameter flow cytometry, we assessed the percentage in leucocytes of lymphocytes and several B cell subpopulations measured in residual disease conditions. CD19+ were also measured in non-residual disease conditions. Clinical examinations were performed by neurologists using the Osserman score. Clinical relapse occurred in 14 patients (41%). No patients required ICU or ventilatory assistance. The mean improvement of the Osserman score was 17.18 (3–45) after the first rituximab treatment ( p