[Multifocal progressive leukoencephalitis in a patient given fludarabine for chronic lymphoid leukemia]

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S Léonard1, C Hulin, R Anxionnat

  • 1Service de neurologie, Hôpital Central, CHU de Nancy, France.

Revue Neurologique
|November 27, 2002
PubMed

Insights

A 74-year-old man developed progressive multifocal leukoencephalopathy (PML) after fludarabine treatment for chronic lymphoid leukemia. JC virus was detected in brain biopsy and CSF, confirming the PML diagnosis and its potential link to the chemotherapy.

Area of Science:

  • Neurology
  • Oncology
  • Infectious Diseases

Background:

  • The patient had a history of chronic lymphoid leukemia (CLL) for 11 years.
  • He received three courses of fludarabine chemotherapy five months prior to hospitalization.

Observation:

  • The patient presented with subacute aphasia and right hemiparesis.
  • Magnetic resonance imaging (MRI) revealed temporo-occipital white matter lesions consistent with progressive multifocal leukoencephalopathy (PML).

Findings:

  • Diagnosis of PML was confirmed by detecting JC virus via in situ hybridization on brain biopsy and polymerase chain reaction (PCR) on cerebrospinal fluid (CSF).

Implications:

  • This case highlights a potential association between fludarabine treatment and the development of PML in patients with hematologic malignancies.
  • It underscores the importance of considering PML in immunocompromised patients presenting with neurological deficits.
  • Further investigation into the causality of fludarabine in PML development is warranted.

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