Skip to main content

ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1520493

Clinical characteristics and immunotherapy response in paraneoplastic neurologic syndrome patients with increased number of high-risk antibodies

Provisionally accepted
Gong Wang Gong Wang Mao Chen Mao Chen Fei Gao Fei Gao Meng Guo Meng Guo Maohua Li Maohua Li 倩 贺 倩 贺 Jiaojin Jiang Jiaojin Jiang Cheng Huang Cheng Huang Xiaoyan Chen Xiaoyan Chen Rui Xu Rui Xu *
  • Department of Neurology, The Second Affiliated Hospital, Army Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

    Objective To investigate the differences of clinical characteristics and treatment outcomes between paraneoplastic neurologic syndrome (PNS) patients with one high-risk antibody and patients with two high-risk antibodies. Methods We retrospectively analyzed the data of 51 PNS patients with high-risk antibody. Clinical data were extracted from the patients' electronic medical records. Clinical presentations, cerebrospinal fluid (CSF) parameters, radiological characteristics and treatment outcomes between patients with one high-risk antibody and patients with two high-risk antibodies were analyzed. Results 41 patients with 1 high-risk antibody and 10 patients with 2 high-risk antibodies were enrolled in this study. It was found that psychobehavioral abnormality (OR = 11.327, 95% CI: 1.371 to 93.602, P = 0.024), bowel and bladder dysfunction (OR = 23.537, 95% CI: 1.753 to 316.005, P = 0.017), and total protein of CSF (OR = 61.556, 95% CI: 2.926 to 1294.974, P = 0.008) were risk factors for increased number of high-risk antibodies in PNS. After immunotherapy treatment, Expanded Disability Status Scale (EDSS) scores in PNS patients with 2 high-risk antibodies were higher than that in PNS patients with 1 high-risk antibody (4.8 ± 2.4 v.s. 3.0 ± 2.4, p = 0.043). EDSS change analysis also revealed that average EDSS score decreased after treatment in PNS with 1 Ab group while increased in PNS with 2 Abs group (p = 0.032). Conclusions Psychobehavioral abnormality, bowel and bladder dysfunction, and total protein of CSF were three variables associated with increased number of high-risk antibodies in PNS patients, while increased number of high-risk antibodies might indicate a poor immunotherapy response. Our findings might help to understand the association of PNS patients' clinical features and high-risk antibodies, as well as to guide clinical practice.

    Keywords: Paraneoplastic neurologic syndromePNS, Number of high-risk antibodies High-risk antibody, Number of antibodies, Risk factors, Immunotherapy response, Clinical features

    Received: 31 Oct 2024; Accepted: 19 Dec 2024.

    Copyright: © 2024 Wang, Chen, Gao, Guo, Li, 贺, Jiang, Huang, Chen and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Rui Xu, Department of Neurology, The Second Affiliated Hospital, Army Medical University, Chongqing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.