Ocrelizumab associated late-onset neutropenia in the patient with multiple sclerosis – case report and literature review

Abstract

Introduction Ocrelizumab is a recombinant humanized monoclonal antibody that selectively depletes CD20-expressing B cells, which is approved for the treatment of the relapsing and primary progressive multiple sclerosis (MS). It is extremely rarely associated with late-onset neutropenia (LON), as an adverse event.

Case outline We describe a case, from the Treatment Registry of the Clinic of Neurology, University Clinical Center of Serbia, Belgrade, of a transient, asymptomatic LON detected in a naïve relapsing–remitting MS patient, six-months after treatment with ocrelizumab.

Conclusion Having in mind all the presently available data, which indicate that rarely occurring LON on ocrelizumab is asymptomatic and transient in the majority of cases, we assume that it may be suggested that only in patients with complaints suggesting the presence of possible infection, additional complete blood count monitoring should be mandatory, exclusively at that moment, apart from the precisely defined regular follow-up.

Keywords: late-onset neutropenia; ocrelizumab; multiple sclerosis