Cargando…
Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome?
Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system resulting from the reactivation of the John Cunningham virus (JCV). PML occurs almost exclusively during profound immune suppression but it can also be observed in immunocompromised subjec...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422031/ https://www.ncbi.nlm.nih.gov/pubmed/36051020 http://dx.doi.org/10.1002/jha2.485 |
_version_ | 1784777727602065408 |
---|---|
author | Vinatier, Emeline Poli, Caroline Giltat, Aurélien Nunes‐Gomes, Christopher Orvain, Corentin Hunault‐Berger, Mathilde Jeannin, Pascale Thépot, Sylvain |
author_facet | Vinatier, Emeline Poli, Caroline Giltat, Aurélien Nunes‐Gomes, Christopher Orvain, Corentin Hunault‐Berger, Mathilde Jeannin, Pascale Thépot, Sylvain |
author_sort | Vinatier, Emeline |
collection | PubMed |
description | Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system resulting from the reactivation of the John Cunningham virus (JCV). PML occurs almost exclusively during profound immune suppression but it can also be observed in immunocompromised subjects as part of an inflammatory immune reconstitution syndrome (IRIS) in patients receiving antiviral therapy. We report a case of PML in a 61‐year‐old patient with acute myeloid leukemia who had developed after discontinuation of durvalumab (anti‐PD‐L1) therapy initiated after multiple treatments. Results suggest that PML may result from two nonexclusive mechanisms: (i) an inhibition of the protective response of JCV‐specific T cells as a consequence of the blockade of the PD1‐PDL1 pathway, associated with a lack of compensatory expression of other inhibitory receptors by T cells and (ii) a neuroinflammatory response (PML‐IRIS) that may have contributed to virus reactivation. |
format | Online Article Text |
id | pubmed-9422031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94220312022-08-31 Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? Vinatier, Emeline Poli, Caroline Giltat, Aurélien Nunes‐Gomes, Christopher Orvain, Corentin Hunault‐Berger, Mathilde Jeannin, Pascale Thépot, Sylvain EJHaem Short Reports Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system resulting from the reactivation of the John Cunningham virus (JCV). PML occurs almost exclusively during profound immune suppression but it can also be observed in immunocompromised subjects as part of an inflammatory immune reconstitution syndrome (IRIS) in patients receiving antiviral therapy. We report a case of PML in a 61‐year‐old patient with acute myeloid leukemia who had developed after discontinuation of durvalumab (anti‐PD‐L1) therapy initiated after multiple treatments. Results suggest that PML may result from two nonexclusive mechanisms: (i) an inhibition of the protective response of JCV‐specific T cells as a consequence of the blockade of the PD1‐PDL1 pathway, associated with a lack of compensatory expression of other inhibitory receptors by T cells and (ii) a neuroinflammatory response (PML‐IRIS) that may have contributed to virus reactivation. John Wiley and Sons Inc. 2022-05-29 /pmc/articles/PMC9422031/ /pubmed/36051020 http://dx.doi.org/10.1002/jha2.485 Text en © 2022 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Short Reports Vinatier, Emeline Poli, Caroline Giltat, Aurélien Nunes‐Gomes, Christopher Orvain, Corentin Hunault‐Berger, Mathilde Jeannin, Pascale Thépot, Sylvain Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? |
title | Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? |
title_full | Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? |
title_fullStr | Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? |
title_full_unstemmed | Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? |
title_short | Progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: A consequence of an immune reconstitution inflammatory syndrome? |
title_sort | progressive multifocal leukoencephalopathy after durvalumab treatment for acute myeloid leukemia: a consequence of an immune reconstitution inflammatory syndrome? |
topic | Short Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422031/ https://www.ncbi.nlm.nih.gov/pubmed/36051020 http://dx.doi.org/10.1002/jha2.485 |
work_keys_str_mv | AT vinatieremeline progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT policaroline progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT giltataurelien progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT nunesgomeschristopher progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT orvaincorentin progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT hunaultbergermathilde progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT jeanninpascale progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome AT thepotsylvain progressivemultifocalleukoencephalopathyafterdurvalumabtreatmentforacutemyeloidleukemiaaconsequenceofanimmunereconstitutioninflammatorysyndrome |