title: Late relapse of progressive multifocal leucoencephalopathy postallogenic transplant in a young patient with CLL.
abstract: We describe a case of progressive multifocal leucoencephalopathy (PML) in a 39-year-old patient diagnosed with chronic lymphocytic leukaemia (CLL) who underwent two allogenic matched-sibling stem cell transplantations. PML was confirmed just after the first transplantation with cerebral MRI and by PCR in the cerebrospinal fluid. After immunosuppression withdrawal and cidofovir treatment, he achieved a reversal of clinical symptoms, John Cunningham (JC) virus positivity and MRI lesions regression. He remained asymptomatic for 5 years with no signs of infection activity, even though he received three new chemotherapy regimens due to a CLL relapse. However, after the second stem cell transplantation, new neurological symptoms began and a reactivation of the JC virus infection was detected. This time, treatment with mefloquine was started, but he experienced a progressive neurological deterioration and died 1 month after the symptoms began.
authors.affiliation: Department of Hematology and Hemotherapy, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Sanchez-Quintana
authors.forename: Joaquín
authors.initials: J
authors.lastname: Breña-Atienza
authors.forename: Carmen
authors.initials: C
authors.lastname: Marrero-Santos
authors.forename: Luis
authors.initials: L
authors.lastname: Alvarez-Acosta
mesh_terms: D000328:Adult; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis*; D012008:Recurrence; D033581:Stem Cell Transplantation; D013997:Time Factors
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