Patient-specific factors modulate leukocyte response in dimethyl fumarate treated MS patients.

Publication date: Aug 28, 2019

Determine if patient-specific factors modulate absolute lymphocyte count (ALC), neutrophil count (ANC), and/or Neutrophile-lymphocyte ratio (NLR) in Dimethyl Fumarate (DMF) treated patients.

A retrospective study of patients who initiated DMF between 2013-2018. A multicenter study of two MS clinics: Charlottesville, VA (UVA) and Dallas, TX (DaVA).

103 patients (67-UVA, 36-DaVA) met eligibility. At baseline, the DaVa population was younger (mean+/-sd: 38.6+/-9.0 vs 42.2+/-12.5, p 0.152) and had a higher proportion of males (61% vs. 35%), consistent with a veteran cohort. Pre-treatment, all other laboratory parameters were similar between the two groups. On treatment there was a 30% lowering of mean ALC, with 3% having grade-3 lymphopenia (ALC

Patient-specific factors, specifically-age, sex, and serum blood glucose, modulate leukocyte response and ratios in DMF treated MS patients. Age appears to be a relevant predictor of lymphopenia and should be a factor in treatment decision making. Neutropenia, independent of lymphopenia, can occur and males may be at increased risk. High sBG may impact leukocyte count and ratios in MS patients and merits further study, particularly in patients with diabetes. NLR is abnormal in MS and increased with DMF-treatment, the clinical implications of this will require further study.

Open Access PDF

Goldman, M.D., Dwyer, L., Coleman, R., Sohn, M.W., and Stuve, O. Patient-specific factors modulate leukocyte response in dimethyl fumarate treated MS patients. 20191. 2019 PLoS One (15):2.

Concepts Keywords
ANC Neutropenia
BMI Relevant predictor lymphopenia
Charlottesville Years Neutropenia
Cohort Significantly predictive lymphopenia
Correlation Independent lymphopenia
Dallas Sustained neutropenia
Diabetes Dimethyl fumarate
Dimethyl Fumarates
DMF Fungicides
Leukocyte Count


Type Source Name
disease MESH optic neuritis
disease MESH Inflammation
drug DRUGBANK Guanosine
disease MESH Syndr
disease MESH morbid obesity
disease MESH diabetes mellitus
disease MESH Mult
drug DRUGBANK Glatiramer
disease MESH sclerosis
drug DRUGBANK Gold
disease MESH cancer
disease MESH stroke
disease MESH glucose intolerance
disease MESH fasting
disease MESH Type 1 diabetes
drug DRUGBANK Esomeprazole
disease MESH diagnosis
disease MESH leukoencephalopathy
drug DRUGBANK Antithymocyte immunoglobulin (rabbit)
disease MESH Neurological Disorders
disease MESH Obesity
disease MESH metabolic syndrome
disease MESH demyelination
disease MESH progressive multifocal leukoencephalopathy
drug DRUGBANK Coenzyme M
disease MESH risk factor
disease MESH relapse
disease MESH Multiple Sclerosis
drug DRUGBANK Dextrose unspecified form
disease MESH neutropenia
disease MESH lymphopenia
drug DRUGBANK Methionine
drug DRUGBANK Dimethyl fumarate

Original Article

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