B-cell Depletion Therapy in Pediatric Neuroinflammatory Disease

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY Current Neurology and Neuroscience Reports Pub Date : 2024-09-11 DOI:10.1007/s11910-024-01366-7

Helen C Wu, Grace Y Gombolay, Jennifer H Yang, Jennifer S Graves, Alison Christy, Xinran M Xiang

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Abstract

Purpose of review

B-cell depletion therapy, including anti-CD20 and anti-CD19 therapies, is increasingly used for a variety of autoimmune and conditions, including those affecting the central nervous system. However, B-cell depletion therapy use can be complicated by adverse effects associated with administration and immunosuppression. This review aims to summarize the application of anti-CD20 and anti-CD19 therapies for the pediatric neurologist and neuroimmunologist.

Recent findings

Most existing literature come from clinical trials with adult patients, although more recent studies are now capturing the effects of these therapies in children. The most common side effects include infusion related reactions and increased infection risk from immunosuppression. Several strategies can mitigate infusion related reactions. Increased infections due to persistent hypogammaglobulinemia can benefit from replacement immunoglobulin.

Summary

B-cell depletion therapies can be safe and effective in pediatric patients. Anticipation and mitigation of common adverse effects through primary prevention strategies, close monitoring, and appropriate symptomatic management can improve safety and tolerability.

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小儿神经炎疾病中的 B 细胞消耗疗法

综述目的B细胞去除疗法，包括抗CD20和抗CD19疗法，正越来越多地用于治疗各种自身免疫性疾病和病症，包括影响中枢神经系统的疾病。然而，B细胞耗竭疗法的使用可能会因用药和免疫抑制相关的不良反应而变得复杂。本综述旨在总结抗 CD20 和抗 CD19 疗法在儿科神经科和神经免疫科中的应用。最常见的副作用包括输液相关反应和免疫抑制引起的感染风险增加。有几种策略可以减轻输液相关反应。由于持续性低丙种球蛋白血症导致的感染增加可从替代免疫球蛋白中获益。通过初级预防策略、密切监测和适当的对症处理来预测和减轻常见的不良反应，可以提高安全性和耐受性。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.