Mefloquine in the treatment of progressive multifocal leukoencephalopathy

  title={Mefloquine in the treatment of progressive multifocal leukoencephalopathy},
  author={Teneille E. Gofton and A Al-Khotani and B. O'Farrell and Lee Cyn Ang and Richard S. McLachlan},
  journal={Journal of Neurology, Neurosurgery \& Psychiatry},
  pages={452 - 455}
Mefloquine, an antimalarial medication with efficacy against JC virus, was used to treat progressive multifocal leukoencephalopathy. A 54-year-old woman with sarcoidosis presented with a progressive cerebellar syndrome. MRI showed lesions affecting the right cerebellum that progressed over time to the brainstem. JC virus was found in the cerebrospinal fluid (CSF), and brain biopsy confirmed the diagnosis of progressive multifocal leukoencephalopathy. Mefloquine 1000 mg/week was initiated 6… 

Mirtazapine and mefloquine therapy for non-AIDS-related progressive multifocal leukoencephalopathy.

The positive clinical response seen in the patient after the initiation of this combination therapy suggests that further studies in the form of randomized controlled trials for the treatment of non-AIDS-related PML are warranted.

Mefloquine improved progressive multifocal leukoencephalopathy in a patient with systemic lupus erythematosus.

A 67-year-old man with systemic lupus erythematosus who presented with progressive left hemiplegia is described, and administration of mefloquine stopped the extension of the lesion, and resulted in obvious clinical improvement.

Favourable outcome of progressive multifocal leukoencephalopathy with mefloquine treatment in combination with antiretroviral therapy in an HIV-infected patient

Following the administration of mefloquine in combination with ART, the patient's neurological status improved substantially and suggests that further investigation of the use of me floquine might be warranted for treatment of PML in HIV-infected patients.

Rituximab-associated progressive multifocal leukoencephalopathy derived from non-Hodgkin lymphoma: neuropathological findings and results of mefloquine treatment.

A 66-year-old man with non-Hodgkin lymphoma developed progressive multifocal leukoencephalopathy (PML) after undergoing chemotherapy including rituximab and a postmortem examination disclosed a severe condition associated with ritUXimab-treated PML originating from NHL and a high mefloquine concentration in the brain.

Mefloquine improved progressive multifocal leukoencephalopathy in a patient with immunoglobulin A nephropathy

Successful treatment of progressive multifocal leukoencephalopathy with mirtazapine and mefloquine in refractory myeloma

The present case suggests that combination therapy of mirtazapine and mefloquine is effective for patients with PML, particularly those requiring immunosuppressive chemotherapy.

Akinetic mutism caused by HIV-associated progressive multifocal leukoencephalopathy was successfully treated with mefloquine: a serial multimodal MRI Study.

A patient with highly active anti-retroviral therapy-resistant human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy showed an improvement in imaging findings and clinical symptoms after mefloquine was introduced as an additional treatment, suggesting that (1)H-MRS and DWI were useful for the assessment of the therapeutic effect on PML.

Late relapse of progressive multifocal leucoencephalopathy postallogenic transplant in a young patient with CLL

A 39-year-old patient diagnosed with chronic lymphocytic leukaemia who underwent two allogenic matched-sibling stem cell transplantations experienced a progressive neurological deterioration and died 1 month after the symptoms began.

Antiviral Therapy for Progressive Multifocal Leukoencephalopathy

From all drugs tested CMX001, mirtazapine and risperdone appear to be most promising, these drugs cross the blood brain barrier (BBB), are well tolerated and show promising results in case reports.



The natural history of progressive multifocal leukoencephalopathy in patients with AIDS. Canadian PML Study Group.

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  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1995
The correlations between CD4+ lymphocyte count, previous diagnosis of AIDS, treatment with cytarabine, and survival time are reported for 28 individuals for whom the diagnosis of PML was confirmed by histopathologic examination.

Progressive multifocal leukoencephalopathy as first manifestation of sarcoidosis

The atypical antipsychotic agents ziprasidone [correction of zisprasidone], risperdone and olanzapine as treatment for and prophylaxis against progressive multifocal leukoencephalopathy.

Some newer atypical antipsychotics such as zisprasidone, risperidone and olanzapine--medicines with much better side effect and toxicity profiles than the older antipsychotic medications--in vitro are significantly more potent 5HT2A receptor antagonists than chlorpromazine or clozapine by in some cases more than a factor of 10, and thus may be useful as treatment for or prophylaxis against PML.

Identification and Characterization of Mefloquine Efficacy against JC Virus In Vitro

In vitro results suggest that mefloquine could be an effective therapy for PML, and quantitative PCR to quantify the number of viral copies in cultured cells shows that me floquine inhibits viral DNA replication.

Progressive multifocal leucoencephalopathy: remission with cytarabine.

A patient with a 14 year history of sarcoidosis developed a progressive left cerebral hemisphere lesion. The clinical diagnosis of progressive multifocal leucoencephalopathy was confirmed by brain

The Human Polyomavirus, JCV, Uses Serotonin Receptors to Infect Cells

It is found that the serotonergic receptor 5HT2AR could act as the cellular receptor for JCV on human glial cells and may be useful in the treatment of progressive multifocal leukoencephalopathy.

Interferon-α and -β Restrict Polyomavirus JC Replication in Primary Human Fetal Glial Cells: Implications for Progressive Multifocal Leukoencephalopathy Therapy

The use of IFN as an adjunct therapy for patients with PML is supported because IFN cannot cross the blood-brain barrier to achieve its direct antiviral effect, and intrathecal administration ofIFN is warranted.

Interferon- alpha and - beta restrict polyomavirus JC replication in primary human fetal glial cells: implications for progressive multifocal leukoencephalopathy therapy.

The use of IFN as an adjunct therapy for patients with PML is supported because IFN cannot cross the blood-brain barrier to achieve its direct antiviral effect, and intrathecal administration ofIFN is warranted.

Modulation of the function of human MDR1 P-glycoprotein by the antimalarial drug mefloquine.