title: Progressive multifocal leukoencephalopathy--a case report and review of the literature.
abstract: BACKGROUND
  Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system which affects the white matter and is caused by reactivation of the JC polyomavirus.
  
  
  METHODS
  We report the case of a 63-year-old man with chronic lymphocytic leukemia who was treated with fludarabine; rituximab and fludarabine; fludarabine, cyclophsphamide and rituximab; and lenalidomide. While he underwent chemotherapy, the patient was diagnosed with PML. After stabilization of PML, the patient underwent non-myeloablative allogeneic bone marrow transplantation as a treatment for chronic lymphocytic leukemia. Unfortunately, after several opportunistic infections, the patient died.
  
  
  CONCLUSIONS
  The patient underwent allogeneic bone marrow transplantation with the expectation that donor-derived competent immunological cells would migrate into the cerebral lesions, maintaining immunological response. The effect of bone marrow transplantation in patients with PML requires investigation in larger patient series.
authors.affiliation: Department of Neuropathology, Institute of Pathology, Medical University Graz, Graz, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Smolle
authors.affiliation: OnkoZentrumZürich, Clinics in the Park, Zurich, Switzerland Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Trojan
authors.affiliation: Lymphoma Program, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, U.S.A.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Schuster
authors.affiliation: Department of Neuropathology, Institute of Pathology, Medical University Graz, Graz, Austria johannes.haybaeck@medunigraz.at.
authors.forename: Johannes
authors.initials: J
authors.lastname: Haybaeck
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000628:therapy; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000150:complications; D014184:Transplantation, Homologous
keywords: JC virus; Leukoencephalopathy; demyelinating diseases; progressive multifocal; therapy