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01-04-2019 | Lymphoma | Case Report

Progressive multifocal leukoencephalopathy treated with nivolumab

Authors: Ethan Hoang, Nancy L. Bartlett, Manu S. Goyal, Robert E. Schmidt, David B. Clifford

Published in: Journal of NeuroVirology | Issue 2/2019

Abstract

Therapy for progressive multifocal leukoencephalopathy (PML) remains challenging since there are no antiviral therapies available for JC virus. Immune reconstitution has improved the prognosis in many settings where PML occurs, but it often is not possible in PML patients with hematologic malignancies. We describe the first biopsy proven PML case where the PD-1 inhibitor nivolumab appears to have stimulated immune activation resulting in effective control of PML in a patient with hematologic malignancy. This report supports further investigation of the utility of checkpoint inhibitors for treating PML where other immune reconstitution options are not available.

Clifford DB (2015) Progressive multifocal leukoencephalopathy therapy. J Neurovirol 21(6):632–636

Cortese I, Smith B, Schindler M, Ohayon J, Monaco MC, Ryschkewitsch C et al (2016) M145 - treatment of progressive multifocal leukoencephalopathy with pembrolizumab, a PD-1 inhibitor. Ann Neurol 80:S166–S167CrossRef

Dyck L, Mills KHG (2017) Immune checkpoints and their inhibition in cancer and infectious diseases. Eur J Immunol 47(5):765–779CrossRefPubMed

Kim HJ, Evoli A (2017) Immune checkpoint inhibitor therapy: a double-edged sword? Neurology 89(11):1101–1102CrossRefPubMed

Martinot M, Ahle G, Petrosyan I, Martinez C, Gorun DM, Mohseni-Zadeh M et al (2018) Progressive multifocal leukoencephalopathy after treatment with nivolumab. Emerg Infect Dis 24(8):1594–1596CrossRefPubMedPubMedCentral

Mateen FJ, Muralidharan R, Carone M, van de Beek D, Harrison DM, Aksamit AJ, Gould MS, Clifford DB, Nath A (2011) Progressive multifocal leukoencephalopathy in transplant recipients. Ann Neurol 70(2):305–322CrossRefPubMedPubMedCentral

Melliez H, Mary-Krause M, Bocket L, Guiguet M, Abgrall S, De Truchis P et al (2018) Risk of progressive multifocal leukoencephalopathy in the combination antiretroviral therapy era in the French hospital database on human immunodeficiency virus (ANRS-C4). Clin Infect Dis 67(2):275–282CrossRefPubMed

Neil EC, DeAngelis LM (2017) Progressive multifocal leukoencephalopathy and hematologic malignancies: a single cancer center retrospective review. Blood Adv 1(23):2041–2045CrossRefPubMedPubMedCentral

Postow MA, Sidlow R, Hellmann MD (2018) Immune-related adverse events associated with immune checkpoint blockade. N Engl J Med 378(2):158–168CrossRefPubMed

Rao M, Valentini D, Dodoo E, Zumla A, Maeurer M (2017) Anti-PD-1/PD-L1 therapy for infectious diseases: learning from the cancer paradigm. Int J Infect Dis 56:221–228CrossRefPubMed

Tan CS, Bord E, Broge TA Jr, Glotzbecker B, Mills H, Gheuens S et al (2012) Increased program cell death-1 expression on T lymphocytes of patients with progressive multifocal leukoencephalopathy. J Acquir Immune Defic Syndr 60(3):244–248CrossRefPubMedPubMedCentral

Title: Progressive multifocal leukoencephalopathy treated with nivolumab
Authors: Ethan Hoang
Nancy L. Bartlett
Manu S. Goyal
Robert E. Schmidt
David B. Clifford
Publication date: 01-04-2019
Publisher: Springer International Publishing
Keyword: Lymphoma
Published in: Journal of NeuroVirology / Issue 2/2019
Print ISSN: 1355-0284
Electronic ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-019-00738-x

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Progressive multifocal leukoencephalopathy treated with nivolumab

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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