Treatment of non-AIDS progressive multifocal leukoencephalopathy with cytosine arabinoside

被引:69
作者
Aksamit, AJ [1 ]
机构
[1] Mayo Clin, Dept Neurol, Rochester, MN 55905 USA
关键词
D O I
10.1080/13550280152537292
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
This open label study determined the outcome of non-AIDS progressive multifocal leukoencephalopathy patients treated with a standard dose of intravenous cytosine arabinoside. Nineteen patients with PML proven by brain biopsy or spinal fluid polymerase chain reaction were treated with intravenous cytosine arabinoside 2 mg/kg per day for 5 days and followed for neurologic outcome by neurologic examination and MRI scanning. Seven of 19 PML patients treated with cytosine arabinoside intravenously improved neurologically. The range of follow-up for these patients was 2.0 to 4.5 years. All were left with neurologic deficits but were functionally improved, and 6 of 7 were able to independently carry out the activities of daily living. Twelve PML patients showed no evidence of response and died rapidly of their disease after treatment (range, 8 days to 6 months). All who survived their neurologic disease recovered from treatment-induced pancytopenia. Cytosine arabinoside given intravenously to non-AIDS PML patients in this small study was associated with a 36% chance of developing stabilization at 1 year. Treatment was associated with significant bone marrow toxicity. The improvement in NEU scan changes in those patients who responded took 6 weeks or longer.
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页码:386 / 390
页数:5
相关论文
共 18 条
[1]   NONRADIOACTIVE IN-SITU HYBRIDIZATION IN PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY [J].
AKSAMIT, AJ .
MAYO CLINIC PROCEEDINGS, 1993, 68 (09) :899-910
[2]   PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY AND CYTARABINE - REMISSION WITH TREATMENT [J].
BAUER, WR ;
TUREL, AP ;
JOHNSON, KP .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1973, 226 (02) :174-196
[3]   PROLONGED SURVIVAL AND PARTIAL RECOVERY IN AIDS-ASSOCIATED PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY [J].
BERGER, JR ;
MUCKE, L .
NEUROLOGY, 1988, 38 (07) :1060-1065
[4]   PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY [J].
BROOKS, BR ;
WALKER, DL .
NEUROLOGIC CLINICS, 1984, 2 (02) :299-313
[5]   HAART improves prognosis in HIV-associated progressive multifocal leukoencephalopathy [J].
Clifford, DB ;
Yiannoutsos, C ;
Glicksman, M ;
Simpson, DM ;
Singer, EJ ;
Piliero, PJ ;
Marra, CM ;
Francis, GS ;
McArthur, JC ;
Tyler, KL ;
Tselis, AC ;
Hyslop, NE .
NEUROLOGY, 1999, 52 (03) :623-625
[6]   Failure of cytarabine in progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection [J].
Hall, CD ;
Dafni, U ;
Simpson, D ;
Clifford, D ;
Wetherill, PE ;
Cohen, B ;
McArthur, J ;
Hollander, H ;
Yainnoutsos, C ;
Major, E ;
Millar, L ;
Timpone, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (19) :1345-1351
[7]  
KEPES JJ, 1975, NEUROLOGY, V25, P1006
[8]  
LIDMAN C, 1991, AIDS, V5, P1039, DOI 10.1097/00002030-199108000-00025
[9]   PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY - REMISSION WITH CYTARABINE [J].
MARRIOTT, PJ ;
OBRIEN, MD ;
MACKENZIE, ICK ;
JANOTA, I .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1975, 38 (03) :205-209
[10]   EFFICACY OF CYTARABINE IN PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY IN AIDS [J].
NICOLI, F ;
CHAVE, B ;
PERAGUT, JC ;
GASTAUT, JL .
LANCET, 1992, 339 (8788) :306-306