Therapeutic Experience of Progressive Multifocal Leukoencephalopathy Development during Ofatumumab Therapy for Chronic Lymphocytic Leukemia

A 79-year-old man experienced cognitive impairment and visual field defects during ofatumumab therapy for chronic lymphocytic leukemia refractory to combination chemotherapy. Magnetic resonance imaging revealed T1-weighted low-intensity and T2-weighted high-intensity lesions with patchy gadolinium e...

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Bibliographic Details
Published in:Internal Medicine 2021/12/15, Vol.60(24), pp.3991-3993
Main Authors: Hashimoto, Yu, Tashiro, Takumi, Ogawa, Ryosuke, Nakamichi, Kazuo, Saijo, Masayuki, Tateishi, Takahisa
Format: Article
Language:English
Subjects:
Aged
Antibodies, Monoclonal, Humanized
Case Report
Cerebrospinal fluid
Chemotherapy
Chronic lymphocytic leukemia
Cognitive ability
Contrast Media
Deoxyribonucleic acid
DNA
DNA viruses
Gadolinium
Humans
Internal medicine
JC Virus
Leukemia
Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy
Leukoencephalopathy
Leukoencephalopathy, Progressive Multifocal - chemically induced
Leukoencephalopathy, Progressive Multifocal - drug therapy
Lymphatic leukemia
Magnetic Resonance Imaging
Male
ofatumumab
Progressive multifocal leukoencephalopathy
Substantia alba
Visual field
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Summary:A 79-year-old man experienced cognitive impairment and visual field defects during ofatumumab therapy for chronic lymphocytic leukemia refractory to combination chemotherapy. Magnetic resonance imaging revealed T1-weighted low-intensity and T2-weighted high-intensity lesions with patchy gadolinium enhancement in the subcortical white matter. A diagnosis of progressive multifocal leukoencephalopathy was made after the detection of John Cunningham virus (JCV) DNA in his cerebrospinal fluid (CSF). Following plasma exchange and the administration of mirtazapine and mefloquine, the JCV DNA levels in the CSF decreased. However, the patient died 55 days after treatment was initiated. Ofatumumab treatment appears to be associated with the development of progressive multifocal leukoencephalopathy.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.6723-20