Progressive multifocal leukoencephalopathy in the context of newer therapies in hematology and review of new treatment strategies.

Abstract

Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal demyelinating disease of the central nervous system (CNS) caused by the reactivation of JC polyomavirus in the CNS. We present a case of a 54-year-old man with follicular lymphoma diagnosed with PML after being treated with anti-CD20 monoclonal antibody-based regimens for several years. Due to the lack of effective treatment choices for PML, the patient was treated with nivolumab, based on recent reports, but succumbed to his disease a few months after diagnosis. In this paper, we focus on reviewing the literature of PML cases correlated with newer agents used in hematology, possible factors affecting disease prognosis, as well as the available data on upcoming therapeutic options for patients with PML. Though newer promising treatments such as anti-PD1 monoclonal antibodies arise, a definitive treatment option is yet to be found. Vigilance, early detection, and prompt intervention play a crucial role in the prognosis of PML in patients with hematological malignancies.

• Authors: Panagiotis T Diamantopoulos, Konstantinos Kalopisis, Aikaterini Tsatsou, Athina Efthymiou, Nefeli Giannakopoulou, Sevastianos Hatzidavid, Nora-Athina Viniou
• Journal: European journal of haematology (Eur J Haematol) Vol. 108 Issue 5 Pg. 359-368 (May 2022) ISSN: 1600-0609 [Electronic] England
• PMID: 35100451 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antibodies, Monoclonal
• Antineoplastic Agents
• Nivolumab

Topics

• Antibodies, Monoclonal (adverse effects)
• Antineoplastic Agents (therapeutic use)
• Hematology
• Humans
• JC Virus
• Leukoencephalopathy, Progressive Multifocal (diagnosis, etiology, therapy)
• Male
• Middle Aged
• Nivolumab (therapeutic use)