The polyneuropathy associated with Waldenstrom's macroglobulinaemia can betreated effectively with chemotherapy and the anti-CD20 monoclonal antibody rituximab

A 50-year-old male developed headache, impaired balance, visual defects and severe deafness. Ten months later he presented with markedly reduced power and tremor of his right arm. Waldenstrom's macroglobulinaemia (WM) with ac companying polyneuropathy was diagnosed. The patient received chemotherapy, which resulted in a partial improvement of the arm tremor. Subsequently, h e was treated with rituximab (4 x 375 mg/m(2)), leading to complete resolut ion of the tremor and the paresis of his arm. Additionally, his headache an d imbalance disappeared. Fifteen months after rituximab therapy he remained free of any neurological symptoms. This is the first report showing that W M-associated polyneuropathy can be treated effectively with a combination o f chemotherapy and the anti-CD20 monoclonal antibody rituximab.