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Post-Transplant Events

Two cases of progressive multifocal leukoencephalopathy after allogeneic hematopoietic cell transplantation and a review of the literature

Bone Marrow Transplantation volume 39, pages 101–107 (2007)Cite this article

An Erratum to this article was published on 07 February 2007

Abstract

Progressive multifocal leukoencephalopathy (PML) is a rare subacute demyelinating disorder of the central nervous system (CNS) caused by the DNA JC human polyomavirus. In immunocompromised hosts, PML is caused by reactivation of a latent infection rather than de novo primary exposure. PML in the setting of hematopoietic cell transplantation (HCT) is exceedingly rare. PML should be considered in the differential diagnosis of HCT recipients, autologous or allogeneic, presenting with worsening of neurological symptoms, especially associated with post-transplant neurodegenerative findings. Although DNA polymerase chain reaction (PCR) of the cerebrospinal fluid (CSF) has emerged as a promising tool for detecting JC virus, a negative result does not rule out PML. Brain biopsy remains the most reliable and accurate method for diagnosing JC virus-associated PML. Presently, there is no universally effective antiviral therapy against JC virus and outcome is fatal in the majority of cases. We hereby describe two cases of PML developing after allogeneic HCT and provide a comprehensive review of the literature.

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Authors and Affiliations

  1. Division of Blood and Marrow Transplantation, Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and Research Institute/University of South Florida, Tampa, FL, USA

    M A Kharfan-Dabaja, E Ayala, J Greene & C Anasetti

  2. Department of Interdisciplinary Oncology and Pathology (Neuropathology), H. Lee Moffitt Cancer Center and Research Institute/University of South Florida, Tampa, FL, USA

    A Rojiani

  3. Department of Interdisciplinary Oncology and Radiology (Neuroradiology), H. Lee Moffitt Cancer Center and Research Institute/University of South Florida, Tampa, FL, USA

    F R Murtagh

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  1. M A Kharfan-Dabaja
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Correspondence to M A Kharfan-Dabaja.

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Kharfan-Dabaja, M., Ayala, E., Greene, J. et al. Two cases of progressive multifocal leukoencephalopathy after allogeneic hematopoietic cell transplantation and a review of the literature. Bone Marrow Transplant 39, 101–107 (2007). https://doi.org/10.1038/sj.bmt.1705548

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