title: Treatment of progressive multifocal leukoencephalopathy with interleukin 7.
abstract: OBJECTIVE
  No reliable treatment options are known for progressive multifocal leukoencephalopathy with underlying immunodeficiency. We describe successful compassionate use of recombinant human interleukin 7 in a patient with idiopathic CD4+ T-cell lymphocytopenia.
  
  
  METHODS
  After the diagnoses of progressive multifocal leukoencephalopathy and idiopathic CD4+ T-cell lymphocytopenia were established, a 61-year-old man was treated with recombinant human interleukin 7 on November 1, 2012. Except for an episode of epilepsia partialis continua on January 16, 2013, a gradual clinical improvement was observed until March. Abnormalities shown on magnetic resonance imaging regressed; JC virus DNA in plasma, likely originating from the brain based on sequencing data, cleared; and increases in peripheral CD4+ T cells and JC virus intrathecal antibodies were observed. One year after treatment, the CD4+ T-cell count returned to baseline and the clinical improvement waned, possibly due to the patient's complex epilepsy. On the latest evaluation on January 14, 2014, the patient's condition was unchanged, with no signs of ongoing central nervous system infection.
  
  
  CONCLUSIONS
  The present case argues strongly for proof of the treatment concept. However, deeper insight into the JC virus and its pathogenesis and the immune response during central nervous system infection as well as further clinical studies are needed before recombinant human interleukin 7 can be recommended for the treatment of other cases of immunodeficiency and progressive multifocal leukoencephalopathy.
authors: Department of Neurology, Nordland Hospital Trust, Bodø, Norway2Department of Clinical Medicine, UiT The Arctic University of Tromsø, Tromsø, Norway.
authors: Karl B
authors: KB
authors: Alstadhaug
authors: Cytheris SA, Issy-les-Moulineaux, France.
authors: Thérèse
authors: T
authors: Croughs
authors: Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway.
authors: Stian
authors: S
authors: Henriksen
authors: Division of Transplantation and Clinical Virology, Department of Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland.
authors: Céline
authors: C
authors: Leboeuf
authors: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors: Irini
authors: I
authors: Sereti
authors: Division of Transplantation and Clinical Virology, Department of Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland7Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
authors: Hans H
authors: HH
authors: Hirsch
authors: Department of Clinical Medicine, UiT The Arctic University of Tromsø, Tromsø, Norway4Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway8Metabolic and Renal Research Group, UiT The Arctic University of Nor.
authors: Christine Hanssen
authors: CH
authors: Rinaldo
mesh_terms: D006801:Humans; D015851:Interleukin-7 / Q000008:administration & dosage / Q000494:pharmacology*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000188:drug therapy*
chemical_list: D015851:Interleukin-7