{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:41:45Z","timestamp":1790991705793,"version":"4.1.0"},"reference-count":40,"publisher":"American Society of Hematology","issue":"21","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,11,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>CANOMAD (chronic ataxic neuropathy, ophthalmoplegia, immunoglobulin M [IgM] paraprotein, cold agglutinins, and disialosyl antibodies) is a rare syndrome characterized by chronic neuropathy with sensory ataxia, ocular, and\/or bulbar motor weakness in the presence of a monoclonal IgM reacting against gangliosides containing disialosyl epitopes. Data regarding associated hematologic malignancies and effective therapies in CANOMAD are scarce. We conducted a French multicenter retrospective study that included 45 patients with serum IgM antibodies reacting against disialosyl epitopes in the context of evocating neurologic symptoms. The main clinical features were sensitive symptoms (ataxia, paresthesia, hypoesthesia; n = 45, 100%), motor weakness (n = 18, 40%), ophthalmoplegia (n = 20, 45%), and bulbar symptoms (n = 6, 13%). Forty-five percent of the cohort had moderate to severe disability (modified Rankin score, 3-5). Cold agglutinins were identified in 15 (34%) patients. Electrophysiologic studies showed a demyelinating or axonal pattern in, respectively, 60% and 27% of cases. All patients had serum monoclonal IgM gammopathy (median, 2.6 g\/L; range, 0.1-40 g\/L). Overt hematologic malignancies were diagnosed in 16 patients (36%), with the most frequent being Waldenstr\u00f6m macroglobulinemia (n = 9, 20%). Forty-one patients (91%) required treatment of CANOMAD. Intravenous immunoglobulins (IVIg) and rituximab-based regimens were the most effective therapies with, respectively, 53% and 52% of partial or better clinical responses. Corticosteroids and immunosuppressive drugs were largely ineffective. Although more studies are warranted to better define the optimal therapeutic sequence, IVIg should be proposed as the standard of care for first-line treatment and rituximab-based regimens for second-line treatment. These compiled data argue for CANOMAD to be included in neurologic monoclonal gammopathy of clinical significance.<\/jats:p>","DOI":"10.1182\/blood.2020007092","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T20:58:38Z","timestamp":1600721918000},"page":"2428-2436","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":69,"title":["CANOMAD: a neurological monoclonal gammopathy of clinical significance that benefits from B-cell\u2013targeted therapies"],"prefix":"10.1182","volume":"136","author":[{"given":"Marie","family":"Le Cann","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, Service d'H\u00e9matologie Clinique, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Assitance Publique des H\u00f4pitaux de Paris (AP1HP), Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Bouhour","sequence":"additional","affiliation":[{"name":"Service d\u2019Electroneuromyographie et Pathologies Neuromusculaires, Hospices Civils de Lyon, Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Viala","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, D\u00e9partement de Neurophysiologie Clinique, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, AP-HP, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0451-2471","authenticated-orcid":false,"given":"Laurence","family":"Simon","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, Service d'H\u00e9matologie Clinique, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Assitance Publique des H\u00f4pitaux de Paris (AP1HP), Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-8090","authenticated-orcid":false,"given":"C\u00e9line","family":"Tard","sequence":"additional","affiliation":[{"name":"Department of Neurology and Movement Disorders, U1172, Centre Hospitalo-Universitaire (CHU) de Lille, Centre de R\u00e9f\u00e9rence des Maladies Neuromusculaires Nord Est Ile de France, Lille, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3717-7961","authenticated-orcid":false,"given":"C\u00e9dric","family":"Rossi","sequence":"additional","affiliation":[{"name":"Service d\u2019H\u00e9matologie, CHU F. 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