Outcome of Progressive Multifocal Leukoencephalopathy Treated by Interleukin-7

Autor: Lajaunie, Rébecca, Mainardi, Ilaria, Gasnault, Jacques, Rousseau, Vanessa, Tarantino, Andrea, Sommet, Agnès, Cinque, Paola, Martin-Blondel, Guillaume, Debard, Alexa, Delobel, Pierre, Pansu, Nathalie, Gollion, Cédric, Benaiteau, Marie, Jacomet, Christine, Mélé, Nicolas, Moulignier, Antoine, Suarez, Felipe, Ruch, Yvon, Tranchant, Christine, Lemaignen, Adrien, Langner-Lemercier, Sophie, Buzele, Rodolphe, Guffroy, Aurelien, Moluçon-Chabrot, Cécile, Tattevin, Pierre, Melica, Giovanna, Badiu, Carmen‐ionela, Cheraud-Bonfort, Chrystel, Salmon, Anne, Alstadhaug, Karl Bjornar, Kuhlmann, F. Matthew, Gorza, Lucas, Wang, Adrien, Wille, Heidi, Curlier, Elodie, Hessamfar, Mojgan, Valour, Florent, Perpoint, Thomas, Koralnik, Igor, Decaestecker, Kevin, Vindrios, William, Guilbert, Anne, Boulesteix, Jean Marc, Verdière, Sylvie Colin De, Roux, Antoine, Patel, Amila, Fabian, Michelle, Harel, Asaff, Wyplosz, Benjamin, Ader, Florence
Přispěvatelé: Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), San Raffaele Scientific Institute, Vita-Salute San Raffaele University and Center for Translational Genomics and Bioinformatics, Immunologie intégrative des tumeurs (UMR 1186), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), This study was not funded.
Rok vydání: 2021
Předmět:
Zdroj: Annals of Neurology
Annals of Neurology, 2022, 91 (4), pp.496-505. ⟨10.1002/ana.26307⟩
ISSN: 1531-8249
0364-5134
DOI: 10.1002/ana.26307⟩
Popis: International audience; Objective: Restoring anti-JC virus (JCV) immunity is the only treatment of progressive multifocal leukoencephalopathy (PML). Interleukin-7 is a cytokine that increases number and function of T cells. We analyzed a population of PML patients who received recombinant human IL-7 (rhIL-7) to estimate survival and its determinants.Methods: After exclusion of patients with missing data or receiving other immunotherapies, findings from 64 patients with proven PML who received rhIL-7 between 2007 and 2020 were retrospectively analyzed. Logistic regression was used to analyze variables associated with one-year survival.Results: Underlying conditions were HIV/AIDS (n = 27, 42%), hematological malignancies (n = 16, 25%), primary immunodeficiencies (n = 13, 20%), solid organ transplantation (n = 4, 6%) and chronic inflammatory diseases (n = 4, 6%). One-year survival was 54.7% and did not differ by underlying condition. Survival was not associated with baseline characteristics, but with a >50% increase in blood lymphocytes (OR 4.1, 95%CI 1.2-14.9) and CD4+ T cells (OR 5.9, 95%CI 1.7-23.3), and a > 1 log copies/mL decrease in cerebrospinal fluid JCV DNA (OR 7.6, 95%CI 1.6-56.1) during the first month after rhIL-7 initiation. Side effects were mainly local and flu-like symptoms (n = 8, 12.5%) and PML-immune reconstitution inflammatory syndrome (IRIS) (n = 5, 8%).Interpretation: In this non-controlled retrospective study, survival did not differ from that expected in HIV/AIDS patients, but might have been improved in those with hematological malignancies, primary immunodeficiencies and transplant recipients. RhIL-7 might have contributed to the increase in blood lymphocytes and decrease in CSF JCV replication that were associated with better survival. ANN NEUROL 2022;91:496-505.
Databáze: OpenAIRE
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