Journal
CASE REPORTS IN ONCOLOGY
Volume 4, Issue 1, Pages 136-142Publisher
KARGER
DOI: 10.1159/000326851
Keywords
Progressive multifocal leukoencephalopathy; Rituximab; Small lymphocytic leukemia; JC virus
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Funding
- US Department of Defense [BC074631, BC083295, PC074289]
- NIH [RO1 CA78590, UO1 CA111294, RO1 CA131944, RO1 CA133774, RO1 CA138791, P50 CA127297]
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We describe a case of progressive multifocal leukoencephalopathy (PML) caused by infection with the human polyomavirus JC virus in a patient with B-cell small lymphocytic leukemia who was treated with rituximab. The first symptoms of PML appeared immediately following the last of five cycles of rituximab, cyclophosphamide and pentostatin.Magnetic resonance imaging revealed changes consistent with PML, although JC virus DNA was not detected by polymerase chain reaction assay of the cerebrospinal fluid. A stereotactic biopsy of the brain showed histological changes consistent with PML, while electron microscopy revealed JC virus particles attached to the nuclei of astrocytes. The patient was treated supportively but died 53 days after the initial onset of symptoms.
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