Progressive multifocal leucoencephalopathy after autologous bone marrow transplantation: a treatment option
- 15 April 2011
- journal article
- case report
- Published by BMJ in BMJ Case Reports
- Vol. 2011 (apr15 1)
- https://doi.org/10.1136/bcr.11.2010.3549
Abstract
A patient with multiple myeloma was treated with high-dose chemotherapy followed by two autologous bone marrow transplantations (ABMTs). Nine months after the second ABMT the patient complained of severe left hemiparesis, paraesthesias, left homonymous visual field defects and gait ataxia. She was diagnosed with progressive multifocal leucoencephalopathy (PML) confirmed by detection of JC virus (JCV) DNA and prescribed cidofovir every other week and mirtazapine daily. Her symptoms and signs remained stable and after 6 months the JCV DNA was undetectable in the cerebrospinal fluid. Repeated MRI scans demonstrated the stabilisation of demyelinating lesion volume; after more than 2 years of follow-up the patient's neurological examination does not show significant variations. Combination of cidofovir and mirtazapine may be helpful in the treatment of PML in HIV-negative patients.Keywords
This publication has 18 references indexed in Scilit:
- Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesisThe Lancet Neurology, 2010
- Determinants of survival in progressive multifocal leukoencephalopathyNeurology, 2009
- Mirtazapine in an HIV-1 infected patient with progressive multifocal leukoencephalopathy.2009
- Effect of plasma exchange in accelerating natalizumab clearance and restoring leukocyte functionNeurology, 2009
- Mirtazapine Use in Human Immunodeficiency Virus–Infected Patients With Progressive Multifocal LeukoencephalopathyArchives of Neurology, 2009
- JC virus VP1 loop-specific polymorphisms are associated with favorable prognosis for progressive multifocal leukoencephalopathyJournal of NeuroVirology, 2009
- Improvement of Progressive Multifocal Leukoencephalopathy After Cidofovir Therapy in a Patient with a Destructive PolyarthritisInfection, 2007
- Progressive multifocal leukoencephalopathy after stem cell transplantation, unsuccessfully treated with cidofovirBone Marrow Transplantation, 2002
- Reversal of CSF positivity for JC virus genome by cidofovir in a patient with systemic lupus erythematosus and progressive multifocal leukoencephalopathyNeurological Sciences, 2001
- Highly Active Antiretroviral Therapy and Progressive Multifocal Leukoencephalopathy: Effects on Cerebrospinal Fluid Markers of JC Virus Replication and Immune ResponseClinical Infectious Diseases, 2000