Progressive Multifocal Leukoencephalopathy after Ibrutinib Therapy for Chronic Lymphocytic Leukemia.
- Author:
Mathias LUTZ
1
;
Arik B SCHULZE
;
Elisabeth REBBER
;
Stefanie WIEBE
;
Tarek ZOUBI
;
Oliver M GRAUER
;
Torsten KESSLER
;
Andrea KERKHOFF
;
Georg LENZ
;
Wolfgang E BERDEL
Author Information
- Publication Type:Case Report
- Keywords: B-Cell chronic lymphocytic leukemia; Ibrutinib; Rituximab; Progressive multifocal leukoencephalopathy; JC virus
- MeSH: Antibodies, Monoclonal; Immune System; Immunocompromised Host; JC Virus; Leukemia, Lymphocytic, Chronic, B-Cell*; Leukoencephalopathy, Progressive Multifocal*; Protein-Tyrosine Kinases; Rituximab
- From:Cancer Research and Treatment 2017;49(2):548-552
- CountryRepublic of Korea
- Language:English
- Abstract: Progressive multifocal leukoencephalopathy (PML) is a devastating neurological disease observed nearly exclusively in immunocompromised patients. Recently, the introduction of monoclonal antibodies significantly inhibiting the immune system such as rituximab has led to an increase in PML cases. Although rituximab-based immunochemotherapy remains the standard of treatment for chronic lymphocytic leukemia (CLL), the importance of Bruton’s tyrosine kinase inhibitors such as ibrutinib is steadily increasing. However, long-term experiences regarding possible side effects of these new substances are rare. Here, we report the development of eventually fatal PML possibly associated with ibrutinib therapy for CLL after multiple prior treatment lines, including rituximab. To the best of our knowledge, this is the first study to report such findings. Since the last course of rituximab was applied over 3 years ago, it is conceivable that the strong B cell inhibition by ibrutinib led to PML. With increased awareness of this potential side effect, further clinical studies are certainly warranted to evaluate this possible association.
