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Letter
Brentuximab vedotin treatment associated with acute and chronic inflammatory demyelinating polyradiculoneuropathies
  1. Guillaume Fargeot1,
  2. Corinne Dupel-Pottier2,
  3. Maeva Stephant1,
  4. Julien Lazarovici3,
  5. Laure Thomas4,
  6. Capucine Mouthon-Reignier5,
  7. Benramdane Riad6,
  8. Patrice Carde7,
  9. Giulia Berzero8,
  10. Camille Tafani9,
  11. Weiss Nicolas10,
  12. Karine Viala11,
  13. Thierry Maisonobe11,
  14. Timothée Lenglet11,
  15. Adrien Wang12,
  16. Laurent Magy13,
  17. Kevin Bihan14,
  18. Nathalie Gaspar15,
  19. David Adams16,
  20. Andoni Echaniz-Laguna16,
  21. Cecile Cauquil1,
  22. Dimitri Psimaras17
  1. 1 Department of Neurology, French National Reference Center for Rare Neuropathies, Bicêtre Hospital, AP-HP, Le Kremlin-Bicetre, France
  2. 2 Department of Neurology, Rene Dubos Hospital, Pontoise, Île-de-France, France
  3. 3 Department of Hematology, Gustave Roussy Institute, Villejuif, France
  4. 4 Regional Pharmacovigilance Center, Henri Mondor Hospital, Créteil, France
  5. 5 Department of Neurology, Centre Hospitalier Sud Francilien Site Gilles de Corbeil, Corbeil-Essonnes, France
  6. 6 Department of Hematology, Rene Dubos Hospital, Pontoise, Île-de-France, France
  7. 7 Department of Hematology, Gustave Roussy institute, Paris-Saclay University, Villejuif, France
  8. 8 AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2-Mazarin et Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière (CRICM), UMRS 975, Paris 75013, France; Inserm U 975, CNRS, UMR 7225, Paris, France
  9. 9 Department of Neurology, Military Training Hospital Percy, Service de Santé des Armées, Paris, France, Military Health Service Academy of Val-de-Grâce, Service de Santé des Armées, Paris, France
  10. 10 Département de Neurologie, Unité de Médecine Intensive Réanimation neurologique, Sorbonne Université, Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, INSERM UMR_S 938, Centre de recherche Saint-Antoine, Maladies métaboliques, biliaires et fibro-inflammatoire du foie, Institute of Cardiometabolism and Nutrition (ICAN), AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
  11. 11 Department of Clinical Neurophysiology, Hôpitaux universitaires Pitié-Salpêtrière-Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
  12. 12 Department of Neurology, Foch Hospital, Suresnes, France
  13. 13 Department of Neurology, National Reference Center for Rare Peripheral Neuropathies, University Hospital, Limoges, France
  14. 14 Regional Pharmacovigilance Center, Department of Pharmacology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
  15. 15 Department of Pediatric and Adolescent Oncology, Gustave Roussy institute, Villejuif, France
  16. 16 Department of Neurology, French National Reference Center for Rare Neuropathies, Bicêtre Hospital, AP-HP, INSERM U1195 & Paris-Saclay University, Le Kremlin-Bicetre, France
  17. 17 AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2-Mazarin et Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière (CRICM), UMRS 975, Paris 75013, France; Inserm U 975, CNRS, UMR 7225, Paris 75013, France, Paris, France
  1. Correspondence to Dr Guillaume Fargeot, Department of Neurology, French National Reference Center for Rare Neuropathies, Bicêtre Hospital, AP-HP, Hopital Bicetre Service de Neurologie Adultes, Le Kremlin-Bicetre 94270, Île-de-France, France; guillaume.fargeot{at}aphp.fr
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http://dx.doi.org/10.1136/jnnp-2020-323124

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    Introduction

    Brentuximab vedotin (BV) is an antibody-drug conjugate composed by an anti-CD30 monoclonal antibody and the anti-microtubule agent monomethyl auristatin E, used for the treatment of relapsed/refractory Hodgkin's lymphoma and non-Hodgkin's lymphoma.

    Peripheral neuropathy is a frequent adverse event of BV treatment, affecting up to 60% to 70% of patients.1 It usually consists of a mild axonal, length-dependent, sensory neuropathy, characterised by numbness and tingling of fingers and toes,1 2 related to the toxic effect of monomethyl auristatin E on axonal microtubules.3 Nonetheless, immune-mediated peripheral neuropathies characterised by prominent motor impairment have also been described,4 suggesting that, similarly to other antineoplastic agents, BV might have the potential to induce or exacerbate inflammatory polyradiculoneuropathies. The aim of this study was to assess the characteristics of inflammatory demyelinating polyradiculoneuropathy associated with BV treatment.

    Patients and methods

    We performed a retrospective research in seven French neurology departments, for all patients who were admitted between January 2013 and December 2019 to investigate a peripheral neuropathy appeared during BV treatment. We selected patients meeting Sjevar et al criteria for the diagnosis of Guillain-Barré syndrome (GBS) (level 1 of diagnostic certainty) or meeting ‘definite’ criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) according to 2010 European Federation of Neurological Societies/Peripheral Nerve Society guideline. We considered the onset as acute, subacute or chronic if the disease nadir was reached within 4 weeks, between 4 to 8 …

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    Footnotes

    • CC and DP contributed equally.

    • Contributors GF, AE-L, GB, CC and DP wrote the manuscript. CD-P, MS, JL, LT, CM-R, BR, PC, CT, WN, KV, TM, TL, AW, LM, KB, NG and DA revised the manuscript for intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JL has received research grants and personal fees from Takeda pharmaceutical company. GF, CD-P, MS, LT, CM-R, BR, GB, CT, WN, KV, TM, TL, AW, LM, KB, NG, DA, AE-L, CC and DP declare that they have no conflict of interest.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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