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Updated: Feb 11, 2026

Murine Renal Transplantation Procedure
Published on: July 10, 2009
Progressive Multifocal Leukoencephalopathy Following Combined Rituximab-Based Immune-Chemotherapy for Post-transplant
M Windpessl1, S Burgstaller1, A Kronbichler2
1Department of Internal Medicine IV, Hematology, Oncology and Nephrology, Academic Teaching Hospital Wels-Grieskirchen, Wels, Austria.
Background:
Transplant recipients are at risk of developing progressive multifocal leukoencephalopathy (PML), an opportunistic infection due to reactivation of JC virus. Post-transplant lymphoproliferative disorders (PTLDs) represent a common malignancy in this population, and antiCD20-therapy has become an established component of its treatment.
Case Presentation:
We describe the first case of a renal allograft transplant recipient with PTLD who received rituximab-based immune-chemotherapy and developed PML shortly thereafter. Despite early suspicion and diagnosis, the disease ran a relentlessly progressive course, and the patient succumbed to his illness shortly thereafter.
Conclusion:
PML should be strongly suspected whenever unusual neurologic symptoms appear in the context of immunosuppression. Clinicians and patients should be aware of the potential for PML after rituximab therapy.
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