Antineoplastics
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Reactions 1257 - 20 Jun 2009 S Antineoplastics Fatal progressive multifocal leukoencephalopathy: case report A 64-year-old woman developed fatal progressive multifocal leukoencephalopathy during treatment with fludarabine, rituximab, mitoxantrone and cyclophosphamide for chronic lymphocytic leukaemia (CLL). The woman was diagnosed with CLL in 2000 and received 12 cycles of fludarabine [dosage not stated] until July 2007. Due to progressive disease, she further received three cycles of rituximab, mitoxantrone, fludarabine and cyclophosphamide [dosages not stated] until October 2007, after which rituximab once a month [dose not stated] was continued up to May 2008. A CT scan then revealed a progressive disease infradiaphragmatic and regression supradiaphragmatic. Within 2 weeks of corticosteroid treatment, the lymphoma reduced in size. After an unspecified duration, she presented with confusion. A brain MRI revealed subcortical and periventricular lesions with an increased signal on T2-weighted image; a fluid attenuated inversion recovery image was suggestive of a vascular origin. Her symptoms progressed and she developed aphasia and weakness on her right leg, which corresponded with an increase in size and number of cerebral lesions. A PCR analysis was positive for JC virus DNA (215 000 copies/mL). Two months after symptoms onset, she died. Author comment: "Antibody deficiency syndrome corresponding to CLL under treatment with chemotherapy and rituximab lead to a severe immunosuppression enabling unusual viral infections such as [progressive multifocal leukoencephalopathy]." Hartmann BL, et al. JC papovavirus leukencephalopathy in a patient with B-CLL receiving long-term chemotherapy in combination with an anti-CD20-antibody. 45th Annual Meeting of the American Society of Clinical Oncology : abstr. e18007, 29 May 2009. Available from: URL: http://www.abstract.asco.org - Austria 801144817 1 Reactions 20 Jun 2009 No. 1257 0114-9954/10/1257-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1257 - 20 Jun 2009
SAntineoplastics
Fatal progressive multifocalleukoencephalopathy: case report
A 64-year-old woman developed fatal progressivemultifocal leukoencephalopathy during treatment withfludarabine, rituximab, mitoxantrone andcyclophosphamide for chronic lymphocytic leukaemia(CLL).
The woman was diagnosed with CLL in 2000 andreceived 12 cycles of fludarabine [dosage not stated] untilJuly 2007. Due to progressive disease, she further receivedthree cycles of rituximab, mitoxantrone, fludarabine andcyclophosphamide [dosages not stated] until October2007, after which rituximab once a month [dose not stated]was continued up to May 2008. A CT scan then revealed aprogressive disease infradiaphragmatic and regressionsupradiaphragmatic. Within 2 weeks of corticosteroidtreatment, the lymphoma reduced in size. After anunspecified duration, she presented with confusion. Abrain MRI revealed subcortical and periventricular lesionswith an increased signal on T2-weighted image; a fluidattenuated inversion recovery image was suggestive of avascular origin. Her symptoms progressed and shedeveloped aphasia and weakness on her right leg, whichcorresponded with an increase in size and number ofcerebral lesions. A PCR analysis was positive for JC virusDNA (215 000 copies/mL). Two months after symptomsonset, she died.
Author comment: "Antibody deficiency syndromecorresponding to CLL under treatment with chemotherapyand rituximab lead to a severe immunosuppression enablingunusual viral infections such as [progressive multifocalleukoencephalopathy]."Hartmann BL, et al. JC papovavirus leukencephalopathy in a patient with B-CLLreceiving long-term chemotherapy in combination with an anti-CD20-antibody.45th Annual Meeting of the American Society of Clinical Oncology : abstr.e18007, 29 May 2009. Available from: URL: http://www.abstract.asco.org -Austria 801144817
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Reactions 20 Jun 2009 No. 12570114-9954/10/1257-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
