title: Progressive multifocal leukoencephalopathy (PML) in a patient with lymphoma treated with rituximab: A case report and literature review.
abstract: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease caused by reactivation of a latent JC polyoma virus. The first cases of PML were described 50 years ago in patients with lymphoma. PML typically occurs in immunocompromised individuals, particularly those infected with HIV. We present a 52-year-old male with lymphoma who was treated with R-CHOP (R: Rituximab; C: Cyclophosphamide; H: Doxorubicin; O: Vincristine; P: Prednisone). After six cycles of therapy, the patients developed tonic-clonic seizure. MRI of the brain showed multiple brain lesions. The pathology of a brain biopsy was diagnostic for PML. We review radiographic and histopathological features of the disease. The literature on PML and its association with immunosuppressant agents is reviewed, and the impact of rituximab and other biological agents in the setting is highlighted.
authors: Specialty Internal Medicine Unit, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Electronic address: jaffar.tawfiq@jhah.com.
authors: Jaffar A
authors: JA
authors: Al-Tawfiq
authors: Specialty Internal Medicine Unit, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
authors: Ramzi W
authors: RW
authors: Banda
authors: Specialty Internal Medicine Unit, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
authors: Riyadh A
authors: RA
authors: Daabil
authors: Pathology Services Division, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
authors: M F
authors: MF
authors: Dawamneh
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001706:Biopsy; D001921:Brain / Q000000981:diagnostic imaging; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced* / Q000473:pathology; D008223:Lymphoma / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011859:Radiography; D000069283:Rituximab / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D000069283:Rituximab
keywords: Lymphoma; PML; R-CHOP; Rituximab