Progressive multifocal leukoencephalopathy after treatment with rituximab, fludarabine and cyclophosphamide in a patient with chronic lymphocytic leukemia
| Autor: | Till Seiler, Tobias Herold, Nicole Schinwald, Manuela Bergmann, Martin Dreyling, Christian Buske, Rupert Egensperger, Friederike F. H. Mumm, Daniel Franke, Christoph Trumm |
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| Rok vydání: | 2011 |
| Předmět: |
Cancer Research
Cyclophosphamide business.industry Multiple sclerosis Chronic lymphocytic leukemia Progressive multifocal leukoencephalopathy JC virus Hematology medicine.disease_cause medicine.disease Leukoencephalopathy Leukemia Oncology hemic and lymphatic diseases Immunology medicine Rituximab business medicine.drug |
| Zdroj: | Leukemia & Lymphoma. 53:169-172 |
| ISSN: | 1029-2403 1042-8194 |
| Popis: | With the introduction of potent immunosuppressive agents, progressive multifocal leukoencephalopathy (PML) as a lethal complication of immune suppression has gained more and more attention during recent years [1]. PML is a mostly fatal, demyelinating disease of the brain caused by the John Cunningham (JC) virus. In diff erent populations the prevalence of this virus is up to 68% in the elderly. It persists in kidney cells and has been detected in the urine of healthy individuals in up to 19% [2]. Reduced immunity caused by HIV/AIDS, cancer, immunosuppressive agents or stem cell transplant can induce reactivation of the JC virus and infection of oligodendrocytes, typically leading to demyelinating brain lesions. As the disease progresses, multiple neurologic symptoms develop and may alter over time, sometimes mimicking the clinical picture of multiple sclerosis or strokes. Patients suff ering from chronic lymphocytic leukemia (CLL), one of the most common indolent lymphomas in the Western world, seem to be more prone to PML (incidence of PML in non-hematologic malignancies: 0.07%; incidence in CLL: 0.5%). While CLL is inherently associated with an immune defect, treatment of CLL with immunosuppressive drugs such as fl udarabine and/or rituximab further increases |
| Databáze: | OpenAIRE |
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