Rituximab for HTLV-1-associated Myelopathy

Inclusion Criteria: * Age 18-80 years * Patients HTLV-1-associated myelopathy (tropical spastic paraparesis) Exclusion Criteria: * Anticipated survival of at least 3 years * Inability to undergo neuroimaging with Magnetic Resonance * Clinically significant hepatic disease as demonstrated by history, clinical exam (ascites, varices), or laboratory findings (LFTs \>2x normal, coagulopathy as described) * Comorbid conditions likely to complicate therapy including but not limited to the following: a history of New York Heart Association class II, III, or IV Congestive Heart Failure; end-stage acquired immune deficiency syndrome * Pregnancy * Malignancy (history of or active) * Concomitant use with antineoplastic, immunosuppressive or immune modulating therapies