title: Progressive multifocal leukoencephalopathy after allogeneic bone marrow transplantation for acute myeloid leukemia.
abstract: Progressive multifocal leukoencephalopathy (PML) is a rare fatal complication of allogeneic bone marrow transplantation (BMT) resulting from chronic immunosuppression and impaired cellular immunity. This report discusses 2 cases of PML in patients with acute myeloid leukemia after allogeneic BMT. Diagnosis was made based on characteristic brain MRI findings and positive PCR results for John Cunningham virus in the cerebrospinal fluid. Unfortunately, therapeutic options are limited and nearly always result in terminal outcomes. Although immunosuppression is an unavoidable risk of allogeneic BMT, these cases highlight a rare, yet fatal, consequence of prolonged T-cell lymphopenia and impaired cellular immunity after allogeneic BMT in this patient population.
authors.affiliation: From the Division of Cancer Medicine, Department of Infectious Disease, and Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Hans C
authors.initials: HC
authors.lastname: Lee
authors.affiliation: From the Division of Cancer Medicine, Department of Infectious Disease, and Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Victor
authors.initials: V
authors.lastname: Mulanovich
authors.affiliation: From the Division of Cancer Medicine, Department of Infectious Disease, and Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Yago
authors.initials: Y
authors.lastname: Nieto
mesh_terms: D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects; D007165:Immunosuppression Therapy / Q000009:adverse effects; D015470:Leukemia, Myeloid, Acute / Q000473:pathology / Q000628:therapy*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D014184:Transplantation, Homologous / Q000009:adverse effects