Abstract Details

Title Evaluation of B-cell Abnormalities in Infants of Breastfeeding Mothers on anti-CD20 Therapies for Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S31 - MS Clinical Decision Making and Special Populations (3:30 PM-3:42 PM)

Poster/Presentation
Number 001

Background

Patients with MS are at high risk of relapses in the postpartum period. Breastfeeding has been demonstrated to have some protective effect against postpartum relapses. However, data in regard to safety of most MS disease modifying therapies in breastfeeding is poorly established, leading to a decision between either early reinitiation of DMT postpartum versus breastfeeding.

Objective Evaluation for B-cell abnormalities in breastfed infants of mothers with multiple sclerosis (MS) who are on anti-CD20 therapies (rituximab, ocrelizumab, ofatumumab).

Design/Methods We retrospectively evaluated 7 patients in our practice at the Rocky Mountain MS Center at the University of Colorado who had breastfed their infants on anti-CD20 therapies. These infants had a CBC and B-cell panel checked through their pediatricians as standard of care after treatment with anti-CD20 postpartum.

Results In all seven of these infants, there were no abnormalities found in either their CD19 or CD20 cell counts. The average age of the mothers with MS was 35.4 years. Typically, B-cell depleting agents were resumed between 1-6 months postpartum. The B-cell panels were checked between 2-12 weeks after their mother had received their infusion (rituximab, ocrelizumab) or 2 weeks after an injection (ofatumumab).

Conclusions In our small retrospective case series, we do not identify any B-cell abnormalities in breastfed infants whose mothers are receiving antiCD20 therapies early in the postpartum period for treatment of multiple sclerosis. Additional patients will likely be added to this case series before presentation as well as further details about the subjects. This data provides additional safety information to this treatment strategy for the infant while maintaining the mother with highly effective immunotherapy treatments for multiple sclerosis.

Authors/Disclosures
Anna Shah, MD (University of Colorado, Neurology Dept) PRESENTER	The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. The institution of Dr. Shah has received research support from Genentech/Roche. Dr. Shah has received personal compensation in the range of $5,000-$9,999 for serving as a Educational Speaker with Rocky Mountain MS Center.
Enrique Alvarez, MD, PhD (University of Colorado)	Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Alvarez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene/BMS. The institution of an immediate family member of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon.