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- W2560836496 abstract "Objective: To assess heamatological modifications associated with natalizumab treatment, and compare with treatment response.Background: Natalizumab is a humanized monoclonal antibody directed against the α4 integrin on leucocytes (α4β1 and α4β7 subunits), resulting in inhibition of leucocyte adhesion to endothelial vascular cell adhesion molecule-1 and subsequent transmigration into the CNS. Consequently, elevated lymphocyte, eosinophil, and monocyte counts in peripheral blood are reported with treatment. This is mirrored by reduction of white cells in cerebrospinal fluid. Haematopoietic mobilization is also reported, and associated with clinical response, although the underlying mechanism is not fully understood.Methods: A retrospective audit was conducted on a cohort of 113 MS patients, treated with natalizumab between August 2006 and July 2015. Complete blood counts (CBCs) were analyzed in all patients, before and every three-months during treatment. CBC results were correlated with clinical and radiological response to natalizumab.Results: In all patients, mean lymphocyte and eosinophil counts rose (mean increase 1.02 and 0.18 x10^9g/liter respectively) within the first three-months of treatment, and remained elevated thereafter. Mean monocyte counts rose continually over nine months. Lymphocytosis (lymphocytes >4 x10^9g/liter) occurred more frequently in patients who responded to treatment (31.7[percnt]) than those who did not (10[percnt]). Atypical/reactive lymphocytes were also more likely to occur in those who responded (36.7[percnt]), than those who did not (10[percnt]). Either could therefore suggest a potential marker of treatment response.Myeloid and lymphoid precursor cells were seen in four patients who responded to treatment (myelocytes/plasmacytoid cells), and one patient who did not (myelocytes). Immunophenotyping in one patient with lymphocytosis demonstrated B and T-cells, with activation markers (CD38+, CD23+, FMC7+). No CBC changes were associated with malignancy.Conclusions: This study adds to existing literature of peripheral blood findings associated with natalizumab, findings could also suggest use of CBC differential cell counts as markers for treatment response. Disclosure: Dr. McNicholas has nothing to disclose. Dr. Kearney has nothing to disclose. Dr. Krakar has nothing to disclose. Dr. Jordan has nothing to disclose. Dr. Sharma has nothing to disclose. Dr. Cox has nothing to disclose. Dr. O9Boyle has nothing to disclose. Dr. Tubridy has received research support from Bayer-Schering, the Health Research Board of Ireland and MS Ireland. Dr. Hutchinson has nothing to disclose. Dr McGuigan has received personal compensation for activities with Biogen , Bayer Healthcare, Merck Serono, Novartis, Genzyme, and Teva CNS." @default.
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- W2560836496 date "2016-04-05" @default.
- W2560836496 modified "2023-09-27" @default.
- W2560836496 title "Haematologic Modifications as Markers of Response to Treatment in Multiple Sclerosis Patients Treated with Natalizumab (P5.288)" @default.
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