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Included in this issue of the ARCHIVES is a case report describing a patient with relapsing-remitting MS who responded favorably to rituximab treatment alone¹ and the preceding letter, which describes a patient with relapsing-remitting MS who responded favorably to rituximab combined with cyclophosphamide. In both instances, the authors also assessed CD19⁺ B cell frequencies in the peripheral blood and spinal fluid of their patients, as we had done in our previous report in the ARCHIVES.² However, in contrast to our data, both of these cases demonstrated complete depletion of CD19⁺ CSF B cells in response to rituximab. Several factors may contribute to the apparent discordance with our results. First, the CSF was sampled during the first few courses of treatment, which represent much earlier samplings than what we had previously reported. We had hypothesized that B cell depletion in the CSF of patients with MS . . . [Full Text of this Article]

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Nancy L. Monson, PhD

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