Journal
JOURNAL OF NEUROVIROLOGY
Volume 28, Issue 2, Pages 335-338Publisher
SPRINGER
DOI: 10.1007/s13365-022-01059-2
Keywords
Progressive multifocal leukoencephalopathy; Intravenous immunoglobulins; Pembrolizumab; Rituximab; Follicular lymphoma
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Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the CNS caused by the human polyomavirus 2 (JCV) and primarily occurs in immunocompromised patients. There is currently no specific antiviral treatment available, but combined treatment with intravenous immunoglobulins, maraviroc, and pembrolizumab has shown some benefits in PML patients.
Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the CNS caused by the human polyomavirus 2 (JCV). PML predominantly occurs in immunocompromised patients. To date, no specific antiviral treatment exists, leaving only restoration of the immune system as possible treatment. In 2019, the monoclonal antibody pembrolizumab was reported as a potential treatment option in PML in a case series. Following case reports could not thoroughly confirm a positive outcome. Pembrolizumab targets the inhibitory programmed cell death protein 1 (PD-1) receptor on lymphocytes and is associated with beneficial expansion of pre-existing virus-specific T cells. Here we describe a patient with PML who benefited from combined treatment with intravenous immunoglobulins, maraviroc, and pembrolizumab.
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