title: Rituximab-associated progressive multifocal leukoencephalopathy derived from non-Hodgkin lymphoma: neuropathological findings and results of mefloquine treatment.
abstract: A 66-year-old man with non-Hodgkin lymphoma (NHL) developed progressive multifocal leukoencephalopathy (PML) after undergoing chemotherapy including rituximab. Although the administration of mefloquine at a dose of 500 mg weekly temporarily led to a dramatic decrease in the copy number of JC Virus DNA in the cerebrospinal fluid, the patient's symptoms gradually worsened. The CD4(+) T count remained continuously low, at least until approximately five months after the last cycle of chemotherapy. A postmortem examination performed 10 months after the onset of PML disclosed a severe condition associated with rituximab-treated PML originating from NHL and a high mefloquine concentration in the brain. The accumulation of further data regarding mefloquine treatment in PML cases may help to elucidate the optimal dosage and time window for effectively treating PML.
authors: Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Japan.
authors: Yasuteru
authors: Y
authors: Sano
authors: Yuta
authors: Y
authors: Nakano
authors: Masatoshi
authors: M
authors: Omoto
authors: Masaki
authors: M
authors: Takao
authors: Eiji
authors: E
authors: Ikeda
authors: Atsunori
authors: A
authors: Oga
authors: Kazuo
authors: K
authors: Nakamichi
authors: Masayuki
authors: M
authors: Saijo
authors: Takashi
authors: T
authors: Maoka
authors: Hironori
authors: H
authors: Sano
authors: Motoharu
authors: M
authors: Kawai
authors: Takashi
authors: T
authors: Kanda
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001344:Autopsy; D001921:Brain / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced / Q000150:complications / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use*; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D015767:Mefloquine