Long-lived plasma cells
Well, I tried to get through the paper you sent regarding Survival of long-lived plasma cells. Even the abstract was somewhat difficult to understand, but at least it does explain one thing regarding the B-cells. As you say, the plasma cells can live on for 20 years and Rituxan does not attack them because of the missing CD20 marker.
Regarding the NDS and NSS scoring, I could not find the exact definition, but I did find a couple of things including a similar type of scoring form, as follows:
It may be a bit hard to read given the 41 kb maximum size. The text reads:
[COLOR=”Blue”]Form used for obtaining the neurologic disability
score. For obtaining a raw neurologic disability score
as used here, the values in the columns marked
“Right” and “Left” are added together. The total
scores for motor function and sensation represent the
degrees of motor and sensory disturbance, respectively.
The scoring system is as follows: no deficit (O), mild
deficit (l), moderate deficit (2), severe deficit (3), and
complete absence of function (4). A score of 0 indicates
no neurologic disability, and a score of 64 corresponds
with full disability.[/COLOR]
I also downloaded a paper by Dyck which includes the following statement:
[COLOR=”blue”]Assessment of neuropathy. Neuropathy symptoms and
deficits were evaluated prospectively by a neurologist
(P.J.D.) using a standardized approach. His neurologic
record was used to determine the Neuropathy Symptom
Score (NSS) (abnormality ≥ 1; the range of possible
scores is 0 to 18) and the Neuropathy Disability Score
(NDS) (abnormality ≥ 2; range of possible scores is 0 to
I guess there must be a scoring form like the one attached which was developed by Dyck et al, but I was unable to find it. And, $400 seems a bit too much to get the form. Also, it seems like there are a few scoring methods available.
I was able to locate the reference to 16 out of 21 patients in the strength test. It came from a study done by A Pestronk et al titled Treatment of IgM antibody associated polyneuropathies using rituximab.
I guess we have to keep looking for longer term study results as well as other information regarding the harm which those plasma cells can continue to inflict long after all the B-cells have been depleted. If that information is in the paper you sent, then I apologize for not seeing it. It was pretty “heavy stuff” for me.