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Published: March 2011

Open Access Gateway

Progressive Multifocal Leukoencephalopathy in a HIV-Negative Patient with Small Lymphocytic Leukemia following Treatment with Rituximab

Chakraborty S.a · Tarantolo S.R.b · Treves J.c · Sambol D.d · Hauke R.J.b · Batra S.K.a, e, f

Author affiliations

aDepartment of Biochemistry and Molecular Biology, University of Nebraska Medical Center, bNebraska Cancer Specialists, cMidwest Neurosurgery and Spine Specialists, dPhysicians of Internal Medicine, eDepartment of Pathology and Microbiology, and fEppley Institute for Cancer Research, University of Nebraska Medical Center, Omaha, Nebr., USA

Corresponding Author

Surinder K. Batra, PhD

Department of Biochemistry and Molecular BiologyEppley Institute for Research in Cancer and Allied DiseasesUniversity of Nebraska Medical Center

Omaha, NE 68198-5870 (USA)

Tel. +1 402 559 5455, E-Mail sbatra@unmc.edu

Co-corresponding author:

Ralph J. Hauke, MD Nebraska Cancer Specialists, P.C.

8303 Dodge Street, Suite 250

Omaha, NE 68127 (USA)

Tel. +1 402 354 8124, E-Mail rhauke@nebraskacancer.com

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Abstract

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.

© 2011 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Published: March 2011

Published online: March 12, 2011
Issue release date: January – April

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0


eISSN: 1662-6575 (Online)

For additional information: https://www.karger.com/CRO


Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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