Detection of human herpesvirus 6 and JC virus in progressive multifocal leukoencephalopathy complicating follicular lymphoma

Am J Hematol. 2001 Jul;67(3):200-5. doi: 10.1002/ajh.1108.

Abstract

Progressive multifocal leukoencephalopathy (PML), a demyelinating infectious disease caused by JC virus (JCV), occurs almost exclusively in immunocompromised patients usually with malignant diseases. We report here a Japanese female with follicular lymphoma who subsequently developed PML. In addition to JCV, human herpesvirus 6 (HHV-6) was detected in the affected brain lesions of the patient by polymerase chain reaction and by in situ hybridization. HHV-6, recognized as a neurotropic virus, is known to be reactivated during immunosuppression and can cause fatal complications such as encephalitis/encephalopathy. It is likely that impaired immunity associated with lymphoma and the additional immunosuppression following cytopenia-inducing chemotherapies predisposed the patient to reactivated HHV-6 infection. Although it remains to be clarified whether HHV-6 plays an important role as a co-agent with JCV in causing demyelination of the brain, our observation alerts physicians to the possible association of HHV-6 with the pathogenesis of PML.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / administration & dosage
  • Bleomycin / adverse effects
  • Brain / pathology
  • Brain / virology
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • DNA, Viral / isolation & purification
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Fatal Outcome
  • Female
  • Herpesviridae Infections / complications
  • Herpesviridae Infections / virology*
  • Herpesvirus 6, Human / isolation & purification*
  • Herpesvirus 6, Human / pathogenicity
  • Herpesvirus 6, Human / physiology
  • Humans
  • Immunity, Cellular / drug effects
  • Immunocompromised Host
  • JC Virus / isolation & purification*
  • JC Virus / pathogenicity
  • JC Virus / physiology
  • Leukoencephalopathy, Progressive Multifocal / etiology
  • Leukoencephalopathy, Progressive Multifocal / pathology
  • Leukoencephalopathy, Progressive Multifocal / virology*
  • Lymphoma, Follicular / complications*
  • Lymphoma, Follicular / drug therapy
  • Magnetic Resonance Imaging
  • Mitoxantrone / administration & dosage
  • Mitoxantrone / adverse effects
  • Nitrosourea Compounds / administration & dosage
  • Nitrosourea Compounds / adverse effects
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / virology*
  • Piperazines / administration & dosage
  • Piperazines / adverse effects
  • Polymerase Chain Reaction
  • Prednisolone / administration & dosage
  • Prednisolone / adverse effects
  • Recurrence
  • Salvage Therapy
  • Vincristine / administration & dosage
  • Vincristine / adverse effects
  • Vindesine / administration & dosage
  • Vindesine / adverse effects
  • Virus Activation

Substances

  • DNA, Viral
  • Nitrosourea Compounds
  • Piperazines
  • Bleomycin
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Mitoxantrone
  • sobuzoxane
  • Vindesine
  • ranimustine