Progressive multifocal leukoencephalopathy after T-cell replete HLA-haploidentical transplantation with post-transplantation cyclophosphamide graft-versus-host disease prophylaxis

Transpl Infect Dis. 2018 Apr;20(2):e12850. doi: 10.1111/tid.12850. Epub 2018 Mar 1.

Abstract

A 52-year-old man suffered from progressive multifocal leukoencephalopathy (PML) after human leukocyte antigen (HLA)-haploidentical transplantation with post-transplantation cyclophosphamide (PTCY). Mirtazapine, mefloquine, and cytarabine failed to improve his symptoms, and he finally died 4.5 months after PML onset. This is the first case report of a patient with PML after HLA-haploidentical transplantation with PTCY. Although T-cell replete HLA-haploidentical transplantation with PTCY has enabled early immune reconstitution, PML should be considered if a patient's mental condition deteriorates.

Keywords: haploidentical transplantation; post-transplantation cyclophosphamide; progressive multifocal leukoencephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Cyclophosphamide / therapeutic use*
  • Graft vs Host Disease / prevention & control*
  • HLA Antigens / genetics*
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Leukoencephalopathy, Progressive Multifocal / etiology*
  • Lymphoma, Follicular / complications
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Male
  • Middle Aged
  • Stem Cell Transplantation / adverse effects*
  • Transplantation, Haploidentical

Substances

  • HLA Antigens
  • Immunosuppressive Agents
  • Cyclophosphamide