Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia

A 79-year-old man experienced cognitive impairment and visual field defects during ofatumumab therapy for chronic lymphocytic leukemia refractory to combination chemotherapy. Magnetic resonance imaging revealed T1-weighted low-intensity and T2-weighted high-intensity lesions with patchy gadolinium e...

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Autores principales: Hashimoto, Yu, Tashiro, Takumi, Ogawa, Ryosuke, Nakamichi, Kazuo, Saijo, Masayuki, Tateishi, Takahisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758456/
https://www.ncbi.nlm.nih.gov/pubmed/34176829
http://dx.doi.org/10.2169/internalmedicine.6723-20
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author Hashimoto, Yu
Tashiro, Takumi
Ogawa, Ryosuke
Nakamichi, Kazuo
Saijo, Masayuki
Tateishi, Takahisa
author_facet Hashimoto, Yu
Tashiro, Takumi
Ogawa, Ryosuke
Nakamichi, Kazuo
Saijo, Masayuki
Tateishi, Takahisa
author_sort Hashimoto, Yu
collection PubMed
description A 79-year-old man experienced cognitive impairment and visual field defects during ofatumumab therapy for chronic lymphocytic leukemia refractory to combination chemotherapy. Magnetic resonance imaging revealed T1-weighted low-intensity and T2-weighted high-intensity lesions with patchy gadolinium enhancement in the subcortical white matter. A diagnosis of progressive multifocal leukoencephalopathy was made after the detection of John Cunningham virus (JCV) DNA in his cerebrospinal fluid (CSF). Following plasma exchange and the administration of mirtazapine and mefloquine, the JCV DNA levels in the CSF decreased. However, the patient died 55 days after treatment was initiated. Ofatumumab treatment appears to be associated with the development of progressive multifocal leukoencephalopathy.
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spelling pubmed-87584562022-01-26 Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia Hashimoto, Yu Tashiro, Takumi Ogawa, Ryosuke Nakamichi, Kazuo Saijo, Masayuki Tateishi, Takahisa Intern Med Case Report A 79-year-old man experienced cognitive impairment and visual field defects during ofatumumab therapy for chronic lymphocytic leukemia refractory to combination chemotherapy. Magnetic resonance imaging revealed T1-weighted low-intensity and T2-weighted high-intensity lesions with patchy gadolinium enhancement in the subcortical white matter. A diagnosis of progressive multifocal leukoencephalopathy was made after the detection of John Cunningham virus (JCV) DNA in his cerebrospinal fluid (CSF). Following plasma exchange and the administration of mirtazapine and mefloquine, the JCV DNA levels in the CSF decreased. However, the patient died 55 days after treatment was initiated. Ofatumumab treatment appears to be associated with the development of progressive multifocal leukoencephalopathy. The Japanese Society of Internal Medicine 2021-06-26 2021-12-15 /pmc/articles/PMC8758456/ /pubmed/34176829 http://dx.doi.org/10.2169/internalmedicine.6723-20 Text en Copyright © 2021 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Hashimoto, Yu
Tashiro, Takumi
Ogawa, Ryosuke
Nakamichi, Kazuo
Saijo, Masayuki
Tateishi, Takahisa
Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
title Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
title_full Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
title_fullStr Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
title_full_unstemmed Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
title_short Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
title_sort therapeutic experience of progressive multifocal leukoencephalopathy development during ofatumumab therapy for chronic lymphocytic leukemia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758456/
https://www.ncbi.nlm.nih.gov/pubmed/34176829
http://dx.doi.org/10.2169/internalmedicine.6723-20
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