4.2 Article

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

Journal

INTERNAL MEDICINE
Volume 60, Issue 24, Pages 3991-3993

Publisher

JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.6723-20

Keywords

progressive multifocal leukoencephalopathy; ofatumumab; chronic lymphocytic leukemia

Funding

  1. JSPS KAKENHI [17K09768]
  2. Research Committee of Prion Disease and Slow Virus Infection, Research on Policy Planning and Evaluation for Rare and Intractable Diseases, Health and Labour Sciences Research Grants, The Ministry of Health, Labour and Welfare, Japan
  3. Grants-in-Aid for Scientific Research [17K09768] Funding Source: KAKEN

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A 79-year-old man developed progressive multifocal leukoencephalopathy during ofatumumab therapy for refractory chronic lymphocytic leukemia, and unfortunately passed away despite treatment.
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 mad 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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