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KMID : 0939920170490020548
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대한암학회지
2017 Volume.49 No. 2 p.548 ~ p.552
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Progressive Multifocal Leukoencephalopathy after Ibrutinib Therapy for Chronic Lymphocytic Leukemia
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Lutz Mathias
Schulze Arik B.
Rebber Elisabeth
Wiebe Stefanie
Zoubi Tarek
Grauer Oliver M.
Kebler Torsten
Kerkhoff Andrea
Lenz Georg
Berdel Wolfgang E.
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Abstract
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Progressive multifocal leukoencephalopathy (PML) is a devastating neurological disease observed nearly exclusively in immunocompromised patients. Recently, the introduction of monoclonal antibodies significantly inhibiting the immune system such as rituximab has led to an increase in PML cases. Although rituximab-based immunochemotherapy remains the standard of treatment for chronic lymphocytic leukemia (CLL), the importance of Bruton’s tyrosine kinase inhibitors such as ibrutinib is steadily increasing. However, long-term experiences regarding possible side effects of these new substances are rare. Here, we report the development of eventually fatal PML possibly associated with ibrutinib therapy for CLL after multiple prior treatment lines, including rituximab. To the best of our knowledge, this is the first study to report such findings. Since the last course of rituximab was applied over 3 years ago, it is conceivable that the strong B cell inhibition by ibrutinib led to PML. With increased awareness of this potential side effect, further clinical studies are certainly warranted to evaluate this possible association.
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KEYWORD
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B-Cell chronic lymphocytic leukemia, Ibrutinib, Rituximab, Progressive multifocal leukoencephalopathy, JC virus
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