Progressive Multifocal Leukoencephalopathy and Monoclonal Antibodies: A Review

被引:63
作者
Bohra, Chandrashekar [1 ,2 ,3 ]
Sokol, Lubomir [1 ,2 ,3 ]
Dalia, Samir [1 ,2 ,3 ]
机构
[1] Univ S Florida, Internal Med Program, Tampa, FL USA
[2] H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA
[3] Mercy Oncol & Hematol Joplin, 100 Mercy Way, Joplin, MO 64804 USA
关键词
progressive multifocal leukoencephalopathy; monoclonal antibodies; JCV; STEM-CELL TRANSPLANTATION; HEMATOPOIETIC PROGENITOR CELLS; MULTIPLE-SCLEROSIS PATIENTS; IMMUNE-DEFICIENCY SYNDROME; NON-HODGKINS-LYMPHOMAS; ADVERSE DRUG EVENTS; JC VIRUS; LYMPHOPROLIFERATIVE DISORDERS; ALEMTUZUMAB CAMPATH-1H; RISK STRATIFICATION;
D O I
10.1177/1073274817729901
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Progressive multifocal leukoencephalopathy (PML) is a viral infection predominantly seen in patients with HIV infection. However, with the increased use of monoclonal antibodies (MAB) for various lymphoproliferative disorders, we are now seeing this infection in non-HIV patients on drugs such as natalizumab, rituximab, and so on. The aim of this article is to review the relationship between the occurrence of PML and MAB used in the treatment of hematological malignancies and autoimmune diseases. Review of articles from PubMed-indexed journals which study PML in relation to the use of MAB. Relevant literature demonstrated an increased risk of reactivation of latent John Cunningham polyomavirus (JCV) resulting in development of PML in patients on long-term therapy with MAB. The highest incidence of 1 PML case per 1000 treated patients and 1 case per 32 000 was observed in patients treated with natalizumab and rituximab, respectively. Serological and polymerase chain reaction tests for the detection of JCV can be helpful in risk stratification of patients for the development of PML before and during therapy with MAB. Treatment with MAB can result in development of PML. Clinicians should include PML in differential diagnosis in patients treated with these agents if they manifest central nervous system symptoms.
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页数:9
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