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Characteristics of progressive multifocal leukoencephalopathy in hematological malignancies, With reference to

Emi Yokoyama1, Taisuke Harada2, Tomoyuki Endo3

  • 1Blood Disorders Center, Aiiku Hospital, Sapporo, Japan. chatte_brillante@yahoo.co.jp.

International Journal of Hematology
|July 24, 2026
PubMed

Insights

Progressive multifocal leukoencephalopathy (PML) is a rare CNS infection. Patients with hematological malignancies had lower IgG levels and a poorer prognosis than those with HIV, indicating a need for increased vigilance.

Area of Science:

  • Neuroimmunology
  • Infectious Diseases
  • Hematology

Background:

  • Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic central nervous system (CNS) infection affecting immunocompromised individuals.
  • PML is associated with JC virus reactivation and can be devastating in immunocompromised hosts.

Purpose of the Study:

  • To compare the clinical course and outcomes of PML in patients with hematological malignancies versus those with human immunodeficiency virus (HIV) infection.
  • To assess the immunological parameters and prognosis of PML in these distinct patient populations.

Main Methods:

  • Retrospective evaluation of clinical data from PML patients at North Japan Hematology Study Group institutions.
  • Comparison of CD4+ T cell counts and IgG levels between PML patients with hematological malignancies and those with HIV infection.
  • Analysis of survival data and time from PML onset to death.

Main Results:

  • Eight PML patients had hematological malignancies, and nine had HIV infection.
  • Patients with hematological malignancies had significantly lower IgG levels (median 643.5 mg/dL) compared to HIV patients (median 1691.5 mg/dL) (p < 0.01).
  • Nearly all patients with hematological malignancies died within 136 days of PML onset, while most HIV patients survived.

Conclusions:

  • PML carries a poor prognosis in patients with hematological malignancies, characterized by lower IgG levels and high mortality.
  • The incidence of PML may rise in hematological malignancy patients due to novel therapies.
  • Increased caution and monitoring are crucial for managing PML in immunocompromised individuals, particularly those with hematological malignancies.
Keywords:
Hematological malignanciesHuman immunodeficiency virus infectionProgressive multifocal leukoencephalopathy

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