AUTHOR=Garbo Riccardo , Cutuli Daniela , Lorenzut Simone , Gigli Gian Luigi , Bagatto Daniele , Valente Mariarosaria 

TITLE=Opportunities and Obstacles Associated With Sequential Immune Reconstitution Therapy for Multiple Sclerosis: A Case Report

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.664596

DOI=10.3389/fneur.2021.664596

ISSN=1664-2295

ABSTRACT=Cladribine is an effective disease modifying treatment for relapsing-remitting multiple sclerosis and acts as an immune reconstitution therapy which is administered in a pulsed way. Despite its efficacy, severe disease reactivation early after treatment could represent a serious clinical problem and clear evidence to guide the management of such a situation is lacking. We describe the case of a patient experiencing considerable disease activity during the first year after the initiation of cladribine treatment. The patient was switched to alemtuzumab therapy without receiving the second course of cladribine, which resulted in a better outcome of the disease activity. However, some infectious complications were observed.