ANTI-MAG ANTIBODY-ASSOCIATED POLYNEUROPATHIES - IMPROVEMENT FOLLOWINGIMMUNOTHERAPY WITH MONTHLY PLASMA-EXCHANGE AND IV-CYCLOPHOSPHAMIDE

Treatment outcomes of sensory-motor polyneuropathies associated with a nti-myelin-associated glycoprotein (MAG) antibodies have varied even w ith relatively intensive immunosuppression. We used plasma exchange an d cyclophosphamide to treat four patients with anti-MAG antibody-assoc iated polyneuropathies whose symptoms had progressed in the preceding year. Treatment courses consisted of five to seven monthly regimens of plasma exchange on 2 consecutive days followed by intravenous cycloph osphamide (1 g/m(2)). Effects of treatment were quantitatively measure d with hand-held dynamometry. All four patients showed improvement in both strength and sensation in the 5 to 24 months after treatment. We conclude that selected patients with sensory-motor polyneuropathies as sociated with high-titer serum IgM autoantibodies against MAG may have quantitative and useful functional improvement after immunotherapy, T he improvement continues after completion of treatment and may persist for 1 to 2 years or longer.