Paraneoplastic ataxic syndrome with anti-Yo antibodies in breast and ovarian cancer: A retrospective analysis.

• DOI: 10.1200/jco.2020.38.15_suppl.e18089
• Publication Date: 2020-05-25T15:37:08Z
• Authors: Akshjot Puri; Usman Khan; Polly Ann Niravath
• Keywords: Paraneoplastic cerebellar degeneration; Cerebellar ataxia

e18089 Background: Paraneoplastic cerebellar syndrome is a rare immunological reaction caused most commonly by Anti-Yo or Purkinje cell cytoplasmic antibody type 1(PCA1) to degeneration protein 2(CDR2), found in the cerebellum and ectopically produced tumor. Most cases are reported women with HER2+ breast ovarian cancers underlying cancer patients having relatively better prognosis. Treatment initiation within one month of symptom onset has shown outcomes. Methods: A retrospective analysis was conducted using clinical database at single institution included 3 diagnosis ataxic symptoms diagnosed between 2016 2020. Data collection age, gender, performance status, site disease, pathology, diagnostic work up, treatment overall survival (OS). Results: The study who presented new median time from being 5 months (range 4-7). Median age 62 years 59-83), all were females functionally independent before onset. Out 2 had (one IHC 3+ equivocal but 20 HER2 signals/nucleus) third carcinoma. All stage IIIA disease as per AJCC 8 th edition bilateral extremity weakness, ataxia, visual disturbances, vertigo nausea/vomiting. Extensive neurological up including MRI brain, CSF analysis, EEG inconclusive except for high titres anti- Yo antibodies patients. treated directed therapy immunomodulation plasma exchange, IVIG steroids. OS 22 12-28) alive albeit there been no recovery, despite IVIG, steroids, exchange. Conclusions: anti-Yo associated paraneoplastic pelvic tumors very poor prognosis anti-tumor immunomodulating therapies, leaving bed-ridden. neurologic damage irreparably incurred once attack cells. Thus, it critical clinicians recognize potential signs early possible, so that can be started, long term minimized. Further studies needed know exact mechanism this provide evidence based options.