Clinical outcome of patients with anti-Hu–associated encephalomyelitis after treatment of the tumor
- 1 November 1999
- journal article
- research article
- Published by Wolters Kluwer Health in Neurology
- Vol. 53 (8), 1719
- https://doi.org/10.1212/wnl.53.8.1719
Abstract
Objective: To evaluate 1) the effect of the tumor treatment on the clinical course of paraneoplastic encephalomyelitis (PEM) with anti-Hu antibodies, 2) the impact of immunotherapy on the tumor evolution, and 3) the outcome of the small cell lung cancer (SCLC) of PEM patients compared with that of patients without PEM. Methods: The authors retrospectively analyzed 51 PEM patients (42 with SCLC, 9 with other tumors) who received antineoplastic treatment with (25 patients) or without (26) concomitant immunotherapy. Tumor response was assessed at the end of the antineoplastic treatment. Progression of PEM was defined as a change of at least 1 point in the Rankin scale measured at the onset and at the end of the tumor treatment. To evaluate the outcome of SCLC, 27 PEM patients with SCLC were matched one-to-one with SCLC patients without PEM for age, performance status, tumor stage, and type of antineoplastic treatment. Results: Thirty-six (70%) patients were neurologically stable at the end of the tumor treatment. In a logistic regression analysis, tumor complete response was the only predictor of PEM stabilization (OR 7.07; 95% CI 1.68 to 29.76; p = 0.006). Immunotherapy did not modify the outcome of the tumor and PEM. Median survival was similar in SCLC patients with and without PEM, but the probability of survival at 30 months was higher in PEM patients with SCLC (OR 5.26; 95% CI 1.0004 to 27.6902; p = 0.03). Conclusions: Complete response of the tumor seems to have a favorable influence on the course of paraneoplastic encephalomyelitis (PEM). Concomitant immunotherapy does not adversely affect the tumor outcome. The small cell lung cancer of PEM patients may have a slightly better evolution than that of patients without PEM.Keywords
This publication has 18 references indexed in Scilit:
- Spontaneous neurological improvement in anti-Hu associated encephalomyelitis.Journal of Neurology, Neurosurgery & Psychiatry, 1997
- Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain.Proceedings of the National Academy of Sciences, 1996
- Intravenous immunoglobulin treatment in paraneoplastic neurological syndromes with antineuronal autoantibodies.Journal of Neurology, Neurosurgery & Psychiatry, 1996
- Anti-tumour therapy in paraneoplastic neurological diseaseClinical Neurology and Neurosurgery, 1995
- Regression of small-cell lung carcinoma in patients with paraneoplastic neuronal antibodiesThe Lancet, 1993
- Plasmapheresis and antineoplastic treatment in CNS paraneoplastic syndromes with antineuronal autoantibodiesNeurology, 1992
- Anti-Hu-Associated Paraneoplastic Encephalomyelitis/Sensory Neuronopathy A Clinical Study of 71 PatientsMedicine, 1992
- The analysis of failure time data in crossover studiesStatistics in Medicine, 1991
- Response of the Lambert‐Eaton myasthenic syndrome to treatment of associated small‐cell lung carcinomaNeurology, 1990
- Best Subsets Logistic RegressionBiometrics, 1989