Brentuximab vedotin
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Demyelinating motor neuropathy of the median nerve: case report An 80-year-old man developed demyelinating motor neuropathy of the median nerve during treatment with brentuximab vedotin for mycosis fungoides (IIb). The man, who had mycosis fungoides (IIb) had previously failed various therapies [specific drugs not stated]. Thereafter, he started receiving brentuximab vedotin 1.8 mg/kg every 3 weeks [route not stated]. He was able to tolerate the first 4 cycles of brentuximab vedotin. However, after cycle 4 he started exhibiting a grade 1 sensory neuropathy on both the hands. The dose of brentuximab vedotin was reduced to 1.2 mg/Kg, following which the man’s neuropathy resolved. During the ninth administration of brentuximab vedotin, he had a partial extravasation after puncture of the median cephalic vein. After about 24 hours, he developed erythema and blistering on the right forearm, which progressed over the next 7 days. The healing of erythema and blistering was slow, but complete during the next 2 weeks [specific interventions not stated]. After 7 days of the extravasation, he complained of tingling paraesthesia, which followed numbness and difficulty grasping with his right hand. A prolonged distal motor latency, motor nerve conduction velocity as well as reduced amplitude and an extinct F-wave of the right median nerve were detected by fractional motor and sensory neurography. Based on the findings a diagnosis of brentuximab vedotin related demyelinating motor neuropathy of the median nerve was made [time to reaction onset and outcome not stated]. Author comment: "[Brentuximab vedotin] is a CD30-directed antibody covalently linked to the cytostatic monomethylauristatin E. According to the literature, release of cytostatic should only occur after CD30 binding and internalization. It has been discussed whether liberation of the cytostatic during cell death might cause side effects. However, in our case, previous CD30 binding appears unlikely and other hitherto unknown release mechanisms must be considered." Hoffmann JC, et al. Demyelinating motor neuropathy of the median nerve following brentuximab vedotin extravasate. European Journal of Cancer 119 (Suppl. 1): S32-S33 abstr. 089, 2019. Available from: URL: http://doi.org/10.1016/ 803435305 S0959-8049%2819%2930599-4 [abstract] - Germany
0114-9954/19/1780-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 23 Nov 2019 No. 1780
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