Antineoplastics
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Reactions 1429 - 24 Nov 2012 S Antineoplastics Progressive multifocal leukoencephalopathy in an elderly patient: case report A 73-year-old woman developed progressive multifocal leukoencephalopathy (PML) while receiving cyclophosphamide, fludarabine, prednisone, rituximab and vincristine. The woman was diagnosed with chronic lymphocytic leukaemia in June 2003. She subsequently began oral fludarabine [dosage not stated], but this was discontinued in December 2004 due to thrombocytopenia. In January 2005, she was hospitalised for Evans syndrome. Two weeks later, she started receiving weekly rituximab [dosage and route not stated] on a "compassionate drug use" regimen. She developed thrombocytopenia attributed to rituximab, and subsequently started receiving cyclophosphamide, vincristine and prednisone [COP cycle; dosages and routes not stated]. She received seven cycles of COP therapy and had a complete response. Following this, she received maintenance rituximab 375 mg/m 3 , every 3 months, through September 2008 (seven cycles). In September 2008, she was diagnosed with cortical blindness at a neurological assessment. She also had paraesthesia and cramping in her lower limbs and loss of strength on the right side of her body. Treatment was discontinued. PML was corroborated by MRI scan. John Cunningham virus was identified in her spinal fluid, confirming a diagnosis of of PML reactivation. Following discontinuation of her treatments, her white blood cell count increased. Her neurological symptoms progressed and she reported reduced strength in her right limb and increased restlessness in her upper arm. Author comment: We describe a documented case of PML caused by John Cunningham virus in a female patient with chronic lymphocytic leukaemia who was treated with rituximab. This clinical case is added to the list of other exceptional cases that have been previously mentioned of patients previously treated with chemotherapy. Del Pozo Ruiz JJ, et al. Progressive multifocal leukoencephalopathy in a patient treated with fludarabine and rituximab. Atencion Farmaceutica 14: 262-265, No. 4, Aug 2012 [Spanish; summarised from a translation] - Spain 803080336 1 Reactions 24 Nov 2012 No. 1429 0114-9954/10/1429-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1429 - 24 Nov 2012
SAntineoplastics
Progressive multifocal leukoencephalopathy inan elderly patient: case report
A 73-year-old woman developed progressive multifocalleukoencephalopathy (PML) while receivingcyclophosphamide, fludarabine, prednisone, rituximab andvincristine.
The woman was diagnosed with chronic lymphocyticleukaemia in June 2003. She subsequently began oralfludarabine [dosage not stated], but this was discontinuedin December 2004 due to thrombocytopenia. InJanuary 2005, she was hospitalised for Evans syndrome.Two weeks later, she started receiving weekly rituximab[dosage and route not stated] on a "compassionate druguse" regimen. She developed thrombocytopenia attributedto rituximab, and subsequently started receivingcyclophosphamide, vincristine and prednisone [COP cycle;dosages and routes not stated]. She received seven cycles ofCOP therapy and had a complete response. Following this,she received maintenance rituximab 375 mg/m3, every3 months, through September 2008 (seven cycles). InSeptember 2008, she was diagnosed with corticalblindness at a neurological assessment. She also hadparaesthesia and cramping in her lower limbs and loss ofstrength on the right side of her body.
Treatment was discontinued. PML was corroborated byMRI scan. John Cunningham virus was identified in herspinal fluid, confirming a diagnosis of of PML reactivation.Following discontinuation of her treatments, her whiteblood cell count increased. Her neurological symptomsprogressed and she reported reduced strength in her rightlimb and increased restlessness in her upper arm.
Author comment: We describe a documented case ofPML caused by John Cunningham virus in a female patientwith chronic lymphocytic leukaemia who was treated withrituximab. This clinical case is added to the list of otherexceptional cases that have been previously mentioned ofpatients previously treated with chemotherapy.Del Pozo Ruiz JJ, et al. Progressive multifocal leukoencephalopathy in a patienttreated with fludarabine and rituximab. Atencion Farmaceutica 14: 262-265, No. 4,Aug 2012 [Spanish; summarised from a translation] - Spain 803080336
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Reactions 24 Nov 2012 No. 14290114-9954/10/1429-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
