Successful treatment of progressive multifocal leukoencephalopathy with low-dose interleukin-2.
A patient with low-grade lymphoma presented 8 months after autologous marrow transplantation with dizziness, aphasia and hemiparesis. Magnetic resonance imaging (MRI) showed an abnormal T2 signal in the frontoparietal region unilaterally. Biopsy of the area demonstrated progressive multifocal leukoencephalopathy positive for JC virus and p53. Treatment with interleukin-2 at 0.5 MU/m2/day i.v. continuous infusion resulted in near complete resolution of symptoms and MRI abnormalities. The absolute number of CD3+CD4+ and CD3-CD56+ cells in the peripheral blood also increased, and the CD4/CD8 ratio normalized. She remains free of evidence of progressive multifocal leukoencephalopathy 1 year off therapy.
Przepiorka
D
D
Department of Hematology, The University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Jaeckle
K A
KA
Birdwell
R R
RR
Fuller
G N
GN
Kumar
A J
AJ
Huh
Y O
YO
McCutcheon
I
I
D001772:Blood Cell Count; D016026:Bone Marrow Transplantation; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017403:In Situ Hybridization; D007376:Interleukin-2 / Q000627:therapeutic use*; D007577:JC Virus / Q000302:isolation & purification*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D014412:Tumor Virus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D004279:DNA, Viral; D007376:Interleukin-2; D016159:Tumor Suppressor Protein p53