Characteristics and outcomes of progressive multifocal leukoencephalopathy in hematologic malignancies and stem cell transplant - a case series

Diego Adrianzen Herrera; Sabarish Ayyappan; Sakshi Jasra; Noah Kornblum; Olga Derman; Aditi Shastri; Ioannis Mantzaris; Amit Verma; Ira Braunschweig; Murali Janakiram

doi:10.1080/10428194.2018.1474523

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Characteristics and outcomes of progressive multifocal leukoencephalopathy in hematologic malignancies and stem cell transplant - a case series

Journal article

Peer reviewed

Characteristics and outcomes of progressive multifocal leukoencephalopathy in hematologic malignancies and stem cell transplant - a case series

Diego Adrianzen Herrera, Sabarish Ayyappan, Sakshi Jasra, Noah Kornblum, Olga Derman, Aditi Shastri, Ioannis Mantzaris, Amit Verma, Ira Braunschweig and Murali Janakiram

Leukemia & lymphoma, Vol.60(2), pp.395-401

01/28/2019

DOI: 10.1080/10428194.2018.1474523

PMID: 29969336

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Abstract

Progressive multifocal leukoencephalopathy (PML) is a life-threatening opportunistic infection of immunomodulatory therapies. PML cases reported in PubMed (1995-2017) following stem-cell transplantation (HSCT) or chemoimmunotherapy (CIT) for hematologic malignancies were reviewed. We found 107 cases, 40% were HSCT recipients (32 allogeneic, 11 autologous) and 40% indolent lymphomas receiving monoclonal antibodies (mAbs). HSCT cases had longer time to PML diagnosis (10.8 vs. 4 months, p < .001), higher proportion of PML therapy response (58% vs. 25%, p = .019), lower mortality rate (56% vs. 88%, p < .001), and longer median survival (8 vs. 2 months, p < .001). Outcome differences might be caused by selection bias as HSCT patients are most likely treated aggressively; however, time-dependent immune reconstitution might also contribute to their better prognosis. Increased use of mAbs and HSCT are associated with rising PML incidence in hematological malignancies, currently constituting the second largest vulnerable population after HIV-infected patients; further research is needed for its optimal treatment.

hematologic malignancies

monoclonal antibodies

Progressive multifocal leukoencephalopathy

stem cell transplantation

Details

Title: Subtitle: Characteristics and outcomes of progressive multifocal leukoencephalopathy in hematologic malignancies and stem cell transplant - a case series
Creators: Diego Adrianzen Herrera - Albert Einstein College of Medicine
Sabarish Ayyappan - The Ohio State University
Sakshi Jasra - Albert Einstein College of Medicine
Noah Kornblum - Albert Einstein College of Medicine
Olga Derman - Albert Einstein College of Medicine
Aditi Shastri - Albert Einstein College of Medicine
Ioannis Mantzaris - Albert Einstein College of Medicine
Amit Verma - Albert Einstein College of Medicine
Ira Braunschweig - Albert Einstein College of Medicine
Murali Janakiram - The Bronx Defenders
Resource Type: Journal article
Publication Details: Leukemia & lymphoma, Vol.60(2), pp.395-401
Publisher: Taylor & Francis
DOI: 10.1080/10428194.2018.1474523
PMID: 29969336
ISSN: 1042-8194
eISSN: 1029-2403
Language: English
Date published: 01/28/2019
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984360147702771

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