Rituximab-associated Progressive Multifocal Leukoencephalopathy Derived from Non-Hodgkin Lymphoma: Neuropathological Findings and Results of Mefloquine Treatment

被引：20

作者：

Sano, Yasuteru ^{[1
]}

Nakano, Yuta ^{[1
]}

Omoto, Masatoshi ^{[1
]}

Takao, Masaki ^{[2
]}

Ikeda, Eiji ^{[3
]}

Oga, Atsunori ^{[3
]}

Nakamichi, Kazuo ^{[4
]}

Saijo, Masayuki ^{[4
]}

Maoka, Takashi ^{[5
]}

Sano, Hironori ^{[1
]}

Kawai, Motoharu ^{[1
]}

Kanda, Takashi ^{[1
]}

机构：

[1] Yamaguchi Univ, Grad Sch Med, Dept Neurol & Clin Neurosci, Yamaguchi, Japan

[2] Tokyo Metropolitan Geriatr Hosp, Dept Neuropathol, Brain Bank Aging Res, Tokyo, Japan

[3] Yamaguchi Univ, Grad Sch Med, Dept Pathol, Yamaguchi, Japan

[4] Natl Inst Infect Dis, Dept Virol 1, Tokyo, Japan

[5] Res Inst Prod Dev, Tsukuba, Ibaraki, Japan

来源：

INTERNAL MEDICINE | 2015年 / 54卷 / 08期

基金：

日本学术振兴会;

关键词：

non-Hodgkin lymphoma; progressive multifocal leukoencephalopathy; rituximab; mefloquine; JC polyoma virus; ADVERSE DRUG EVENTS; MULTIPLE-SCLEROSIS; IN-VITRO; NATALIZUMAB; THERAPY; PATIENT; PROJECT; DISEASE;

D O I：

10.2169/internalmedicine.54.2308

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 66-year-old man with non-Hodgkin lymphoma (NHL) developed progressive multifocal leukoencephalopathy (PML) after undergoing chemotherapy including rituximab. Although the administration of mefloquine at a dose of 500 mg weekly temporarily led to a dramatic decrease in the copy number of JC Virus DNA in the cerebrospinal fluid, the patient's symptoms gradually worsened. The CD4(+) T count remained continuously low, at least until approximately five months after the last cycle of chemotherapy. A postmortem examination performed 10 months after the onset of PML disclosed a severe condition associated with rituximab-treated PML originating from NHL and a high mefloquine concentration in the brain. The accumulation of further data regarding mefloquine treatment in PML cases may help to elucidate the optimal dosage and time window for effectively treating PML.

引用

页码：965 / 970

页数：6

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