Table 3.
Beneficial effects of immunotherapy on cerebellar ataxia with paraneoplastic cerebellar degeneration. Summary of 20 studies.
| Age/Gender | Associated Neoplasm/Treatment | Delay | Autoantibodies/MRI | Immunotherapy | Outcome/follow-up Period (Months) | |
|---|---|---|---|---|---|---|
| Moll et al. (1993) | ||||||
| 44/F | Breast cancer. Surg, chemo | 13 days | Not identified. No atrophy | plasmapheresis IVIg | Gait with assistance → gait without assistance 8 | |
| Stark et al. (1995) | ||||||
| 61/F | Ovarian tube cancer. Surg, chemo | 2.5 m | Not identified. Mild atrophy | oral PSL (no effect), CS, CP | Gait with wheel chair →gait with assistance. 54 | |
| 51/F | Ovarian cancer. Surg | 24 days | Not identified. ND | CP | Moderate ataxic gait → minimal ataxic gait. 24 | |
| David et al. (1996) | ||||||
| 81/F | Ovarian cancer. No cancer therapy | 2 m | Anti-Yo Ab. Mild atrophy | plasmapheresis, IVIg | Gait with assistance → gait no assistance. 2 (symptom deterioration 3 m later) | |
| Blaes et al. (1999) | ||||||
| patient 1: 62/F | Peritoneal carcinomatosis. Chemo | ND | Anti-Yo Ab. ND | IVIg | Marked reduction of ataxia. 24 | |
| Batocchi et al. (1999) | ||||||
| 47/F | Pelvic endometroid cancer. Surg, chemoradio | 6 m | Anti-Yo Ab. Mild atrophy | CP | ? → gait with wheel chair, 21 | |
| Mowzoon & Bradley (2000) | ||||||
| 56/F | Unknown | 19 m | Not identified. Mild atrophy | IVIg, oral PSL, CP | Gait with wheel chair → gait with cane, 18 | |
| Shams’ili et al. (2006) | ||||||
| patient 4: 48/F | Ovarian cancer. Surg | 1 m | Anti-Yo. ND | Rituximab | Modified Rankin scale 4→3, 16 | |
| Taniguchi et al. (2006) | ||||||
| 53/M | Hogkin's lymphoma, Chemoradio | immediate | Anti-Tr Ab. ND | IVIg, plasmapheresis | Improvement in standing and gait disturbances | |
| Geromin et al. (2006) | ||||||
| 17/F | Hogkin's lymphoma, Chemoradio | ND | Anti-Tr Ab. Mild atrophy | IVIg | Severe nystagmus, dysarthria → mild nystagmus, dysarthria, 120 | |
| Phuphanich & Brock (2007) | ||||||
| 72/F | Papillary carcinoma (extraovarian origin). chemo | 12 m | Anti-Yo Ab. Atrophy | IVIg | ? → able to swallow, 18 | |
| 54/F | Ovarian cancer. Surg, chemo | 6 m | Anti-Yo Ab. ND | IVIg | Gait with wheel chair → gait with assistance, Unknown | |
| Thöne et al. (2008) | ||||||
| 86/F | Ovarian cancer. No cancer therapy | 5 m | Anti-Yo Ab. No atrophy | mPSL, oral PSL, CP | Gait with assistance → gait with walking frame, 4 | |
| Esposito et al. (2008) | ||||||
| 48/F | Lung small cell carcinoma. Chemoradio | 12 m | Anti-Hu Ab. No atrophy | Rituximab | ICARS 40→11, 24 | |
| Schessl et al. (2011) | ||||||
| 72/F | Ovarian cancer. Surg, chemo | ND | Anti-Yo Ab. No atrophy | IVIg, oral PSL, rituximab | Gait with assistance decrease in falling, 120 | |
| Age/Gender | Associated Neoplasm/Treatment | Delay | Autoantibodies/MRI | Immunotherapy | Outcome/follow-up Period (Months) | |
| Shimazu et al. (2012) | ||||||
| 55/M | Lymphoma. Chemo | 3 m | Not identified Mild atrophy | Rituximab | SARA 30→1, 15 | |
| Yeo et al. (2012) | ||||||
| 10/M | Hodgkin’s lymphoma. Chemoradio | 2 years | Anti-Tr Ab. ND | Rituximab, IVIg | Gait with a walker → gait with assistance, 36 | |
| Lakshmaiah et al. (2013) | ||||||
| 68/M | Lymphoma. Chemo | 2 m | Not identified. Mild atrophy | Rituximab | There was a significant improvement in cerebellar signs, 8 | |
| Bhargava et al. (2014) | ||||||
| 44/F | Ovarian cancer. Surg | ~10 m | Anti Yo Ab. Mild atrophy | IVIg | Modified Rankin scale 4→2 2 | |
| Mitchell et al. (2015) | ||||||
| 75/F | Lung cancer. Surg | 3 m | Anti-Ri Ab. No atrophy | Plasmapheresis, IVIg | Nearly complete clinical recovery, 24 | |
| Zhu et al. (2016) | ||||||
| 68/M | Bladder cancer. Surg | 5 days | Not identified. No atrophy | mPSL | Barthel index of activities of daily living, 35→85 | |
| Gungor et al. (2017) | ||||||
| 11/F | Hodgkin’s lymphoma. Chemo | 1 wk | Anti-Tr Ab. No atrophy | Plasmapheresis, IVIg | Gait with assistance → gait without assistance, Unknown | |
Abbreviations: Surg: surgery, chemo: chemotherapy, chemoradio: chemoradiotherapy, mPSL; intravenous methylprednisolone, oral PSL; oral prednisolone, IVIg; intravenous immunoglobulins, CS: cyclosporine, CP: cyclophosphamide, ND: Not described.