Cytarabine therapy for progressive multifocal leukoencephalopathy in patients with AIDS.
To evaluate the efficacy and safety of intravenous cytarabine in the treatment of AIDS-associated progressive multifocal leukoencephalopathy (PML), we reviewed the charts of all human immunodeficiency virus-infected patients with PML who were seen during a 28-month period at our institution. Patients with biopsy-proven PML were offered therapy with intravenous cytarabine (2 mg/[kg.d] for 5 days every 4 weeks). The diagnosis of PML was histologically confirmed for 13 patients. The median CD4 cell count was 91 x 10(6)/L. A median of three courses of cytarabine was administered to eight patients. Two patients developed mild drug-related toxicities. Clinical and/or radiological signs of improvement were observed for three patients treated with cytarabine; no signs of improvement were noted for the untreated patients. Median survival time after the diagnosis of PML was 102 days (range, 46-220 days) for patients who received cytarabine and 60 days (range, 28-72 days) for untreated patients matched for Karnofsky scores (P = .06, logrank test). Although cytarabine is well tolerated by patients with AIDS and PML, only modest short-term clinical improvement in the conditions of patients treated with the drug has been observed, with no significant impact on survival.
Moreno
S
S
Department of Clinical Microbiology, Hospital General Universitario, Gregorio Marañón, Madrid, Spain.
Miralles
P
P
Díaz
M D
MD
Berenguer
J
J
Bernaldo de Quirós
J C
JC
Blázquez
R
R
Cosín
J
J
Bouza
E
E
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use* / Q000633:toxicity; D003561:Cytarabine / Q000627:therapeutic use* / Q000633:toxicity; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000998:Antiviral Agents; D003561:Cytarabine