Review of Progressive Multifocal Leukoencephalopathy and Natalizumab

  title={Review of Progressive Multifocal Leukoencephalopathy and Natalizumab},
  author={Allen Jr. Aksamit},
  journal={The Neurologist},
  • A. Aksamit
  • Published 1 November 2006
  • Medicine, Psychology
  • The Neurologist
Background:Progressive multifocal leukoencephalopathy (PML), a destructive demyelinating infection which lytically infects oligodendrocytes, has occurred in patients treated with natalizumab. Magnetic resonance imaging (MRI) scan imaging of the brain gives clues to diagnosis but is nonspecific in distinguishing multiple sclerosis from PML. Spinal fluid detection of JC virus is specific but incompletely sensitive. Associated immunosuppression is typically of the cell-mediated type but can be… 

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Progressive multifocal leukoencephalopathy: A review of the pathology and pathogenesis

  • A. Aksamit
  • Biology, Medicine
    Microscopy research and technique
  • 1995
JC virus may be reactivated from a latent state in both the brain and in non‐central nervous system (CNS) organs at the time of immunosuppression, leading to clinical disease.

Progressive Multifocal Leukoencephalopathy.

  • Berger
  • Medicine, Biology
    Current treatment options in neurology
  • 2000
Almost 7% to 9% of patients with PML demonstrate prolonged survival and associated improvement in clinical and radiographic abnormalities in the absence of specific therapy, and Interferon alfa may improve survival in patients with AIDS and PML and may have general applicability to PML regardless of the cause of the underlying immunodeficient state.

Progressive multifocal leukoencephalopathy in a patient treated with natalizumab.

The clinical course of a patient with multiple sclerosis in whom progressive multifocal leukoencephalopathy (PML) developed during treatment with interferon beta-1a and a selective adhesion-molecule blocker, natalizumab is described.

Progressive multifocal leukoencephalopathy after natalizumab therapy for Crohn's disease.

Analysis of frozen serum samples showed that JC virus DNA had appeared in the serum three months after the initiation of open-label natalizumab monotherapy and two months before the appearance of symptomatic PML, suggesting that anti-alpha4-integrin therapy can result in JC virus-induced PML.

Progressive multifocal leukoencephalopathy in patients with HIV infection.

Progressive multifocal leukoencephalopathy often heralds AIDS and may occur in the absence of significant decline in CD4 lymphocytes, and survival is generally poor, although prolonged survival beyond 1 year is not unusual.

A controlled trial of natalizumab for relapsing multiple sclerosis.

In a placebo-controlled trial, treatment with natalizumab led to fewer inflammatory brain lesions and fewer relapses over a six-month period in patients with relapsing multiple sclerosis.

Cellular and humoral immune response in progressive multifocal leukoencephalopathy

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Progressive multifocal leukoencephalopathy: molecular biology, pathogenesis and clinical impact.

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Progressive multifocal leukoencephalopathy in 47 HIV-seropositive patients: neuroimaging with clinical and pathologic correlation.

The authors investigated the spectrum of radiologic findings in a large series (n = 47) of patients seropositive to human immunodeficiency virus (HIV) 1 and with pathologically proved progressive