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Transduction-Transplantation Mouse Model of Myeloproliferative Neoplasm
Published on: December 22, 2016
Progressive multifocal leukoencephalopathy in transplant recipients
Farrah J Mateen1, RajaNandini Muralidharan, Marco Carone
1Department of Neurology, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA. fmateen@jhsph.edu
Annals of Neurology
|August 9, 2011
Summary
Transplant recipients face a risk of progressive multifocal leukoencephalopathy (PML), a JC virus-induced brain condition. Bone marrow recipients have longer survival but faster symptom onset compared to solid organ recipients.
Area of Science:
- Neurology
- Infectious Diseases
- Transplantation Medicine
Background:
- Transplant recipients are susceptible to progressive multifocal leukoencephalopathy (PML), a severe demyelinating disease.
- PML is caused by the JC virus, leading to oligodendrocyte destruction.
Purpose of the Study:
- To investigate the incidence, characteristics, and outcomes of PML in transplant recipients.
- To compare PML development and survival between solid organ and bone marrow transplant recipients.
Main Methods:
- A comprehensive literature search using PubMed Entrez (1958-2010) was conducted.
- A multicenter retrospective cohort study identified PML cases at four major academic medical centers.
- Incidence was calculated at one institution for heart and/or lung transplant recipients.
Main Results:
- Sixty-nine cases of post-transplantation PML were identified (44 solid organ, 25 bone marrow).
- Median time to PML symptoms was shorter in bone marrow recipients (11 months) versus solid organ recipients (27 months).
- Median survival was 6.4 months for solid organ and 19.5 months for bone marrow recipients; overall case fatality was 84%.
Conclusions:
- PML risk persists throughout the post-transplantation period.
- Bone marrow recipients experience longer survival but potentially faster symptom onset.
- Post-transplantation PML exhibits higher fatality and potentially higher incidence than in HIV/HAART or natalizumab-treated multiple sclerosis patients.
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