Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia
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- Hashimoto Yu
- Department of Neurology, Japan Community Health Care Organization Kyushu Hospital, Japan Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan
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- Tashiro Takumi
- Department of Neurology, Japan Community Health Care Organization Kyushu Hospital, Japan
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- Ogawa Ryosuke
- Department of Hematology, Japan Community Health Care Organization Kyushu Hospital, Japan
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- Nakamichi Kazuo
- Department of Virology 1, National Institute of Infectious Diseases, Japan
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- Saijo Masayuki
- Department of Virology 1, National Institute of Infectious Diseases, Japan
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- Tateishi Takahisa
- Department of Neurology, Japan Community Health Care Organization Kyushu Hospital, Japan Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
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Abstract
<p>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 made 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. </p>
Journal
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- Internal Medicine
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Internal Medicine 60 (24), 3991-3993, 2021-12-15
The Japanese Society of Internal Medicine
