By Eleanor McDermid, Senior medwireNews Reporter
Patients with rapid recovery of CD4-positive T cells after alemtuzumab treatment formultiple sclerosis (MS) are at risk for disease progression or relapse, research suggests.
The difference was apparent from 3 months after treatment, implying the potential for individualized treatment protocols based on CD4+ counts, say lead researcher Neil Robertson (Cardiff University, UK) and colleagues.
“The association between disease activity and early lymphocyte recovery is not surprising, as MS is primarily a cell-mediated disorder,” they write in Neurology. “However, this relationship has not been demonstrated in vivo before.”
The researchers assessed 56 patients (40 women) given alemtuzumab 12 mg daily for 5 days to treat symptoms of MS. They observed an initial “profound depletion” of lymphocyte subsets, followed by gradual recovery.
CD19+ cells were the first to recover, reaching the 25th percentile of average pretreatment levels at 3-6 months after treatment. These were followed by CD8+ cells, which reached a similar level after 6-9 months.
Patients’ average CD4+ cell counts remained below the 25th of pretreatment levels for up to 24 months of follow up (they received a second alemtuzumab course 12 months after initial treatment). However, recovery of CD4+ cells differed between patients who did and did not exhibit disease activity during follow up.
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