Therapeutic plasma exchange for a case of refractory opsoclonus myoclonus ataxia syndrome. Issue 2 (19th September 2017)

• Record Type: Journal Article
• Authors: Greensher, Jocelyn E.; Louie, James; Fish, Jonathan D.
• Is Part Of: Pediatric blood & cancer. Volume 65:Issue 2(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-09-19
• Subjects: opsoclonus myoclonus ataxia syndrome -- paraneoplastic -- therapeutic plasma exchange; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.26819
• Languages: English
• ISSNs: 1545-5009

Abstract

Abstract: Opsoclonus myoclonus ataxia syndrome (OMAS) can be refractory to standard therapies and devastating. Alternative treatments are imperative. A 14‐month‐old male diagnosed with neuroblastoma and paraneoplastic OMAS achieved complete cancer remission with chemotherapy. The OMAS, however, persisted over the subsequent 4 years despite numerous immune‐modulatory and immunosuppressive therapies. The patient ultimately achieved complete remission following therapeutic plasma exchange (TPE) combined with rituximab and intravenous immunoglobulin. After three asymptomatic years, he relapsed. Upon reintroducing TPE and rituximab plus oral prednisolone, the patient rapidly achieved a second complete remission. This case offers proof‐of‐principle for the potential efficacy of TPE for neuroblastoma‐associated OMAS.