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Department of Neurology, Hospital Clinic i Provincial, Hospital "Principes de Espana," Hospitalet Llobregat, Barcelona, Spain (Drs. Graus, Arbaiza, and Tolosa)
Department of Neurology, Hospital "Principes de Espana," Hospitalet Llobregat, Barcelona, Spain (Dr. Reñé)
Department of Neurology, Hôpital Salpétrière, Paris, France (Drs. Vega and Delattre)
Unit of Neurology, Hospital "Verge de la Cinta" Tortosa, Tarragona, Spain (Dr. Bonaventura).
We retrospectively evaluated the effect of plasmapheresis (PE) in seven patients with paraneoplastic encephalomyelitis (PEM), small-cell lung carcinoma, and anti-Hu antibodies, and four patients with paraneoplastic cerebellar degeneration (PCD), ovarian or breast cancer, and anti-Yo antibodies. In addition to PE, patients received prednisone (nine), cyclophosphamide (eight), or treatment of the tumor (five). All but one patient were severely disabled by the time PE began. The clinical outcome was compared with that of five patients (PEM, four; PCD, one) who only had treatment of the tumor. Only one of these five patients had a severe neurologic deficit at the onset of the antineoplastic treatment. No patient improved. Two patients treated with PE and antineoplastic therapy and three who only received treatment of the tumor remained stable for at least 6 months. Four of the five patients with a stable course started the treatment when the neurologic deficit was not severe. We conclude that the efficacy of PE with other immunosuppressive therapies in the stabilization of the neurologic deficit is uncertain.
Address correspondence and reprint requests to Dr. Francesc Graus, Department of Neurology, Hospital Clinic i Provincial, Villarroel 170, 08036 Barcelona, Spain.
Supported in part by grant FIS 89/0058, Madrid, Spain.
Received March 15, 1991. Accepted for publication in final form August 23, 1991.
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