SynthesisNeurology(R) neuroimmunology & neuroinflammation2021
Longitudinally Extensive Myelitis Associated With Immune Checkpoint Inhibitors.
Open access · goldAbstract readSystematic Review
In one paragraph
Synthesis in Neurology(R) neuroimmunology & neuroinflammation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
4.1field-weighted citation impact, top 4% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Clinical characteristics, management and outcomes in immune checkpoint inhibitor-induced central nervous system demyelinating disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Beyond T cell toxicity - Intrathecal chemokine CXCL13 indicating B cell involvement in immune-related adverse events following checkpoint inhibition: A two-case series and literature review.European journal of neurology · 2024Pooled it
- Immune checkpoint inhibitor neurotoxicity: long-term outcomes with focus on 1-year neurological sequelae.Journal for immunotherapy of cancer · 2026Article
- Severe Immune-Related Neurological Adverse Events Associated With Immune Checkpoint Inhibitor Treatment: A Retrospective Single-Center Study.European journal of neurology · 2026Article
- Case Report: Observational use of mycophenolate mofetil in probable steroid-unresponsive immune checkpoint inhibitor-associated transverse myelitis.Frontiers in immunology · 2026Article
- Severe neuromyelitis optica spectrum disorder induced by pucotenlimab: a case report and literature review.Frontiers in immunology · 2026Review
- Neurological immune-related adverse events with checkpoint inhibitor therapy: challenges for the neurologist.Journal of neurology, neurosurgery, and psychiatry · 2025Review
- Immune Checkpoint Inhibitor-Induced Central and Peripheral Neurotoxicity: Case Series and Literature Review.Cureus · 2025Article
- Longitudinally extensive transverse myelitis after pembrolizumab and lenvatinib therapy for a rare subtype of renal cell carcinoma: A case report.Oncology letters · 2025Article
- Autoimmune GFAP astrocytopathy manifesting as sintilimab-induced myelitis: a Case Report and literature review.Frontiers in immunology · 2025Review
- Review
- Neurological Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors.Biomedicines · 2024Review
- Neurological Adverse Events Related to Immune Checkpoint Inhibitors: A Practical Review.Pharmaceuticals (Basel, Switzerland) · 2024Review
- How I treat unique and difficult-to-manage cases of CAR T-cell therapy-associated neurotoxicity.Blood · 2023Article
- Review
- High Dose Cyclophosphamide for the Treatment of Severe Immune Checkpoint Inhibitor Related Adverse Events.Journal of oncology research and therapy · 2023Article
- Case series: Immune checkpoint inhibitor-induced transverse myelitis.Frontiers in neurology · 2023Article
- Lethal form of a late-onset aquaporin-4 antibody-positive NMOSD related to the immune checkpoint inhibitor nivolumab.Journal of neurology · 2022Article
- Longitudinal extensive transverse myelitis after chemoradiation therapy with durvalumab, a rare complication: case report.BMC neurology · 2022Article
- Drug-related immune-mediated myelopathies.Frontiers in neurology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 1 institution in 1 country.
Alberto PiccaFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Giulia BerzeroFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Kevin BihanFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Vincent JachietFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Edouard JanuelFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Marc CoustansFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Cecile CauquilFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Julie PerrinFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Pablo BerlangaFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Nora KramkimelFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Bethsabée GarelFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Perrine DevicFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
François DucrayFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Marion BenazraFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Flavie BompaireFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Delphine LeclercqFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Jean-Marie MichotFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.ORCID 0000-0003-3482-3331
Samy AmmariFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Dimitri PsimarasFrom the Department of Brain and Behavioral Sciences (A.P., G.B.), University of Pavia, Italy; Regional Pharmacovigilance Center (K.B.), Department of Pharmacology, APHP; APHP (V.J., E.J.), Hôpital Saint-Antoine, Paris; CHI de Cornouaille (M.C.), Quimper; Service de Neurologie (C.C.), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicetre; Hôpitaux Privés de Metz (J.P.), Metz; Gustave Roussy (P.B.), Université Paris-Saclay, Villejuif; Service de Dermatologie (N.K., B.G.), Cochin Hospital AP-HP, Paris; Centre Hospitalier Universitaire Lyon Sud (P.D.), Hospices Civils de Lyon, Pierre-Bénite; Hospices Civils de Lyon (F.D.), Hôpital Neurologique, Bron; Inserm (M.B.), CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM), Paris; OncoNeuroTox Group (F.B.), Hôpital Percy, Clamart; Service de Neuroradiologie (D.L.), AP-HP Pitié-Salpêtrière, Paris; Département d'Innovation Thérapeutique et d'Essais Précoces (J.-M.M.), Gustave Roussy, Villejuif; Department of Diagnostic Radiology (S.A.), Gustave Roussy, Villejuif; and Service de Neurologie 2 (D.P.), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France. dimitri.psimaras@aphp.fr.
Université Paris-Saclay · FR
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo define the characteristics and the outcome of myelitis associated with immune checkpoint inhibitors (ICIs).
methodsWe performed a retrospective research in the databases of the French Pharmacovigilance Agency and the OncoNeuroTox network for patients who developed myelitis following treatment with ICIs (2011-2020). A systematic review of the literature was performed to identify similar cases.
resultsWe identified 7 patients who developed myelitis after treatment with ICIs (anti-PD1 [n = 6], anti-PD1 + anti-CTLA4 [n = 1]). Neurologic symptoms included paraparesis (100%), sphincter dysfunction (86%), tactile/thermic sensory disturbances (71%), and proprioceptive ataxia (43%). At the peak of symptom severity, all patients were nonambulatory. MRI typically showed longitudinally extensive lesions, with patchy contrast enhancement. CSF invariably showed inflammatory findings. Five patients (71%) had clinical and/or paraclinical evidence of concomitant cerebral, meningeal, caudal roots, and/or peripheral nerve involvement. Despite the prompt discontinuation of ICIs and administration of high-dose glucocorticoids (n = 7), most patients needed second-line immune therapies (n = 5) because of poor recovery or early relapses. At last follow-up, only 3 patients had regained an ambulatory status (43%). Literature review identified 13 previously reported cases, showing similar clinical and paraclinical features. All patients discontinued ICIs and received high-dose glucocorticoids, with the addition of other immune therapies in 8. Clinical improvement was reported for 10 patients.
conclusionMyelitis is a rare but severe complication of ICIs that shows limited response to glucocorticoids. Considering the poor functional outcome associated with longitudinally extensive myelitis, strong and protracted immune therapy combinations are probably needed upfront to improve patient outcome and prevent early relapses.
Indexed as
AdolescentAdultAgedFemaleGlucocorticoidsHumansImmune Checkpoint InhibitorsImmunotherapyMagnetic Resonance ImagingMaleMiddle AgedMyelitisNeoplasmsRetrospective StudiesGlucocorticoidsImmune Checkpoint Inhibitors
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