Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project

被引：664

作者：

Carson, Kenneth R. ^{[2
]}

Evens, Andrew M. ^{[1
,3
]}

Richey, Elizabeth A. ^{[1
]}

Habermann, Thomas M. ^{[4
]}

Focosi, Daniele ^{[5
]}

Seymour, John F. ^{[6
]}

Laubach, Jacob ^{[7
]}

Bawn, Susie D. ^{[8
]}

Gordon, Leo I. ^{[1
,3
]}

Winter, Jane N. ^{[1
,3
]}

Furman, Richard R. ^{[9
]}

Vose, Julie M. ^{[10
]}

Zelenetz, Andrew D. ^{[9
,11
]}

Mamtani, Ronac ^{[9
]}

Raisch, Dennis W. ^{[12
]}

Dorshimer, Gary W. ^{[13
]}

Rosen, Steven T. ^{[1
,3
]}

Muro, Kenji ^{[14
]}

Gottardi-Littell, Numa R. ^{[15
]}

Talley, Robert L. ^{[16
]}

Sartor, Oliver ^{[17
]}

Green, David ^{[1
,3
]}

Major, Eugene O. ^{[18
]}

Bennett, Charles L. ^{[1
,3
,19
]}

机构：

[1] Northwestern Univ, Div Hematol Oncol, Feinberg Sch Med, Chicago, IL 60611 USA

[2] Washington Univ, Sch Med, Siteman Comprehens Canc Ctr, St Louis, MO USA

[3] Robert H Lurie Comprehens Canc Ctr, Chicago, IL USA

[4] Mayo Clin, Coll Med, Dept Hematol, Rochester, MN USA

[5] Univ Pisa, Div Hematol, Pisa, Italy

[6] Peter MacCallum Canc Ctr, Div Haematol & Med Oncol, Melbourne, Australia

[7] Dana Farber Canc Inst, Boston, MA 02115 USA

[8] Stanford Univ, Sch Med, Div Hematol Oncol, Stanford, CA 94305 USA

[9] New York Presbyterian Hosp, Cornell Med Ctr, Div Hematol Oncol, New York, NY USA

[10] Univ Nebraska, Med Ctr, Hematol Oncol Sect, Omaha, NE USA

[11] Mem Sloan Kettering Canc Ctr, Div Hematol Oncol, New York, NY 10021 USA

[12] Univ New Mexico, Vet Adm Cooperat Studies Program, Clin Res Pharm Coordinating Ctr, Albuquerque, NM 87131 USA

[13] Univ Penn Hlth Syst, Penn Hosp, Philadelphia, PA USA

[14] Northwestern Univ, Dept Neurol Surg, Feinberg Sch Med, Chicago, IL 60611 USA

[15] Northwestern Univ, Dept Pathol, Feinberg Sch Med, Chicago, IL 60611 USA

[16] Kansas City Canc Ctr, Kansas City, MO USA

[17] Tulane Med Sch, New Orleans, LA USA

[18] Natl Inst Neurol Disorders & Stroke, Lab Mol Med & Neurosci, NIH, Bethesda, MD USA

[19] Jesse Brown VAMC, Vet Adm Ctr Management Complex Chron Condit, Chicago, IL USA

来源：

BLOOD | 2009年 / 113卷 / 20期

关键词：

B-CELL LYMPHOMA; IDIOPATHIC THROMBOCYTOPENIC PURPURA; SYSTEMIC-LUPUS-ERYTHEMATOSUS; CHEMOTHERAPY PLUS RITUXIMAB; MULTIPLE-SCLEROSIS PATIENTS; OF-THE-LITERATURE; JC VIRUS VIREMIA; ANTIBODY NATALIZUMAB; FOLLICULAR LYMPHOMA; INFECTED PATIENTS;

D O I：

10.1182/blood-2008-10-186999

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Rituximab improves outcomes for persons with lymphoproliferative disorders and is increasingly used to treat immune-mediated illnesses. Recent reports describe 2 patients with systemic lupus erythematosus and 1 with rheumatoid arthritis who developed progressive multifocal leukoencephalopathy (PML) after rituximab treatment. We reviewed PML case descriptions among patients treated with rituximab from the Food and Drug Administration, the manufacturer, physicians, and a literature review from 1997 to 2008. Overall, 52 patients with lymphoproliferative disorders, 2 patients with systemic lupus erythematosus, 1 patient with rheumatoid arthritis, 1 patient with an idiopathic autoimmune pancytopenia, and 1 patient with immune thrombocytopenia developed PML after treatment with rituximab and other agents. Other treatments included hematopoietic stem cell transplantation (7 patients), purine analogs (26 patients), or alkylating agents (39 patients). One patient with an autoimmune hemolytic anemia developed PML after treatment with corticosteroids and rituximab, and 1 patient with an autoimmune pancytopenia developed PML after treatment with corticosteroids, azathioprine, and rituximab. Median time from last rituximab dose to PML diagnosis was 5.5 months. Median time to death after PML diagnosis was 2.0 months. The case-fatality rate was 90%. Awareness is needed of the potential for PML among rituximab-treated persons. (Blood. 2009;113:4834-4840)

引用

页码：4834 / 4840

页数：7

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