B cell Depletion Therapy Resulting in Sustained Remission of Severe Autoimmune Complications Following Alemtuzumab Treatment of Multiple Sclerosis.

Abstract Secondary autoimmune disorders (AID) are a recognised complication of alemtuzumab treatment for multiple sclerosis. We have previously reported two female multiple sclerosis patients treated with alemtuzumab who developed rare but severe secondary AID; acquired haemophilia A and autoimmune encephalitis with seizures. Both cases proved to be refractory to treatment with conventional immuno-therapy. However, treatment of the patients with anti-CD20 therapy resulted in sustained remission. This observation validates anti-CD20 therapy as a potential treatment option in patients with autoimmune complications of alemtuzumab that are postulated to arise as a result of B cell hyperpopulation.