%A Koska,Valeria %A Förster,Moritz %A Brouzou,Katja %A Hatami,Maryam %A Arat,Ercan %A Aytulun,Ahmet %A Albrecht,Philipp %A Aktas,Orhan %A Küry,Patrick %A Meuth,Sven G. %A Kremer,David %D 2021 %J Frontiers in Neurology %C %F %G English %K Marburg MS,malign MS,high dose cyclophosphamide (HiCy),Ocrelizumab,Neurofilament %Q %R 10.3389/fneur.2021.696807 %W %L %M %P %7 %8 2021-June-23 %9 Case Report %# %! Successful stabilization of Marburg MS %* %< %T Case Report: Successful Stabilization of Marburg Variant Multiple Sclerosis With Ocrelizumab Following High-Dose Cyclophosphamide Rescue %U https://www.frontiersin.org/articles/10.3389/fneur.2021.696807 %V 12 %0 JOURNAL ARTICLE %@ 1664-2295 %X The Marburg variant of multiple sclerosis (Marburg MS) is the most aggressive form of MS, often leading to death soon after onset. Here we describe the case of a 26-year-old Marburg MS patient presenting with severe neurological deficits requiring intensive care. In spite of more than 100 gadolinium-enhancing MRI lesions, the patient recovered almost completely upon high-dose cyclophosphamide (HiCy) rescue treatment (four consecutive days with 50 mg/kg/day, cumulative absolute dose of 14 g). Following the acute treatment, her disease was stabilized by B cell depletion using ocrelizumab. Clinical amelioration was reflected by a decrease of MRI activity and a marked decline of serum neurofilament light chain levels. HiCy rescue treatment followed by ocrelizumab as a maintenance therapy prevented permanent disability and achieved an almost complete clinical and drastic radiological improvement in this Marburg MS patient.