Progressive multifocal leukoencephalopathy after CAR T therapy

Konstantinos Sdrimas, Meilin Diaz-Paez, Jose F. Camargo, Lazaros J. Lekakis

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Progressive multifocal leukoencephalopathy (PML) remains a life-threatening central nervous system infection in immunocompromised patients. Although outcomes have improved in cases that immune reconstitution is feasible with anti-retroviral therapy (ART) in HIV + patients or natalizumab removal in those with multiple sclerosis, in individuals with hematological malignancies, the prognosis is usually dismal. Anti-viral treatments have been largely ineffective, but immunotherapy-based approaches with checkpoint inhibitors and adoptive virus-specific T cells’ transfer are currently explored in clinical trials. PML has not been described as a cause of encephalopathy after CAR T therapy. We report the first case of PML 7 months after lymphodepleting chemotherapy with fludarabine/cyclophosphamide and anti-CD19-directed CAR T therapy in a patient with relapsed diffuse large B-cell lymphoma who relapsed fast after a previous autologous hematopoietic stem cell transplant. She remains alive 12 months after diagnosis with stabilization of her symptoms with a combination of therapies targeting viral replication and immunotherapy.

Original languageEnglish (US)
Pages (from-to)118-121
Number of pages4
JournalInternational journal of hematology
Volume112
Issue number1
DOIs
StatePublished - Jul 1 2020

Keywords

  • Adoptive cell therapy
  • CAR-T
  • Immunotherapy
  • PML

ASJC Scopus subject areas

  • Hematology

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