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Progressive multifocal leukoencephalopathy following chemotherapy for lung cancer

Antonio Palmieri1, L Valentinis, S Bazzano

  • 1Department of Neurology, Hospital of Portogruaro, Portogruaro, VE, Italy. antonio.palmieri@ulss10.veneto.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|February 18, 2011
PubMed

Insights

Progressive multifocal leukoencephalopathy (PML), a fatal brain disease from JC virus, can occur in immunocompromised patients. This case highlights chemotherapy as a potential, though uncommon, trigger for PML in advanced cancer patients.

Area of Science:

  • Neurology
  • Oncology
  • Infectious Diseases

Background:

  • Progressive multifocal leukoencephalopathy (PML) is a rare, fatal demyelinating disease of the central nervous system.
  • PML is caused by the John Cunningham (JC) virus and typically affects immunocompromised individuals.
  • Risk factors include HIV/AIDS, hematological malignancies, autoimmune diseases, and certain immunomodulatory therapies.

Observation:

  • A case study of a 76-year-old male patient with advanced non-small cell lung cancer is presented.
  • The patient developed PML following six cycles of carboplatin/gemcitabine chemotherapy.
  • Transient leucopenia was noted during the chemotherapy treatment.

Findings:

  • Chemotherapy, specifically carboplatin/gemcitabine, is identified as a potential, albeit uncommon, factor associated with PML development.
  • The patient's advanced non-small cell lung cancer and subsequent chemotherapy regimen preceded the onset of PML symptoms.
  • The case underscores a possible link between specific chemotherapeutic agents and iatrogenic immunosuppression leading to PML.

Implications:

  • This case suggests that clinicians should consider PML in cancer patients undergoing chemotherapy, especially those with other risk factors for immunosuppression.
  • Further research is warranted to elucidate the precise mechanisms by which chemotherapy may contribute to PML.
  • Awareness of this association can aid in earlier diagnosis and management of PML in the oncology setting.

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