Contributions
Abstract: P667
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Neurofilament light chain(NfL) is a biomarker for neuro-axonal damage and is elevated in CSF and serum of multiple sclerosis (MS) patients. An ultrasensitive single-molecule array (Simoa) has been developed to reliably detect NfL levels in serum. In adult MS, CSF and serum NfL (sNfL) are highly correlated and the levels are associated with future disease activity.
Objectives: We aimed to explore these associations in pediatric patients with acquired demyelinating syndromes (ADS).
Methods: in total, 102 children < 18 years with a first attack of demyelination and 23 symptomatic pediatric controls were included. CSF NfL was tested by the commercially available ELISA (Uman Diagnostics); serum NfL was tested with the Simoa NfL light assay. Hazard ratio (HR) were calculated with Cox regression analysis.
Results: Of the 102 patients, 47 (46%) were tested for CSF NfL. The median time from onset to serum-sampling was 4.7 weeks (IQR 1.8-10.4). CSF and serum NfL correlated significantly in the total group (ρ 0.532, p< 0.001) and in the subgroup of patients with future CDMS diagnosis (ρ 0.773, p< 0.001). Serum NfL was higher in patients than in controls (geometric mean (GM) 36.1 pg/ml vs 6.7 pg/mL, p< 0.001)), and was highest in ADS presenting with ADEM (n=28; GM 100.4 pg/mL), followed by patients with future CDMS diagnosis(n=40; GM 32.5 pg/mL), and non-ADEM patients who remained monophasic (n=34; GM 17.6 pg/mL). Serum NfL levels higher than >26.7 pg/mL at baseline are associated with a shorter time to CDMS diagnosis in non-ADEM patients (p=0.045). The HR for CDMS diagnosis was 1.04 for each 10 pg/mL increase of sNfL, after correction for age (p=0.023).
Conclusion: CSF and serum NfL correlate well and sNfL predicts CDMS diagnosis in non-ADEM ADS patients
Disclosure: Yu Yi M. Wong - nothing to disclose
E. Daniëlle van Pelt - nothing to disclose
Christian Barro - nothing to disclose Zuzanna Michalak - nothing to disclose Rinze F. Neuteboom - participates in trials with Sanofi Genzyme and Novartis.
Jens Kuhle - received speaker fees, research support, travel support, and/or served on advisory boards by ECTRIMS, Swiss MS Society, Swiss National Research Foundation, (320030_160221), University of Basel, Bayer, Biogen, Genzyme, Merck, Novartis, Protagen AG, Roche, Teva.
Rogier Q. Hintzen - Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis
Abstract: P667
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Neurofilament light chain(NfL) is a biomarker for neuro-axonal damage and is elevated in CSF and serum of multiple sclerosis (MS) patients. An ultrasensitive single-molecule array (Simoa) has been developed to reliably detect NfL levels in serum. In adult MS, CSF and serum NfL (sNfL) are highly correlated and the levels are associated with future disease activity.
Objectives: We aimed to explore these associations in pediatric patients with acquired demyelinating syndromes (ADS).
Methods: in total, 102 children < 18 years with a first attack of demyelination and 23 symptomatic pediatric controls were included. CSF NfL was tested by the commercially available ELISA (Uman Diagnostics); serum NfL was tested with the Simoa NfL light assay. Hazard ratio (HR) were calculated with Cox regression analysis.
Results: Of the 102 patients, 47 (46%) were tested for CSF NfL. The median time from onset to serum-sampling was 4.7 weeks (IQR 1.8-10.4). CSF and serum NfL correlated significantly in the total group (ρ 0.532, p< 0.001) and in the subgroup of patients with future CDMS diagnosis (ρ 0.773, p< 0.001). Serum NfL was higher in patients than in controls (geometric mean (GM) 36.1 pg/ml vs 6.7 pg/mL, p< 0.001)), and was highest in ADS presenting with ADEM (n=28; GM 100.4 pg/mL), followed by patients with future CDMS diagnosis(n=40; GM 32.5 pg/mL), and non-ADEM patients who remained monophasic (n=34; GM 17.6 pg/mL). Serum NfL levels higher than >26.7 pg/mL at baseline are associated with a shorter time to CDMS diagnosis in non-ADEM patients (p=0.045). The HR for CDMS diagnosis was 1.04 for each 10 pg/mL increase of sNfL, after correction for age (p=0.023).
Conclusion: CSF and serum NfL correlate well and sNfL predicts CDMS diagnosis in non-ADEM ADS patients
Disclosure: Yu Yi M. Wong - nothing to disclose
E. Daniëlle van Pelt - nothing to disclose
Christian Barro - nothing to disclose Zuzanna Michalak - nothing to disclose Rinze F. Neuteboom - participates in trials with Sanofi Genzyme and Novartis.
Jens Kuhle - received speaker fees, research support, travel support, and/or served on advisory boards by ECTRIMS, Swiss MS Society, Swiss National Research Foundation, (320030_160221), University of Basel, Bayer, Biogen, Genzyme, Merck, Novartis, Protagen AG, Roche, Teva.
Rogier Q. Hintzen - Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis