Improvement in progressive multifocal leukoencephalopathy after pembrolizumab-induced immune reconstruction inflammatory syndrome in a patient with follicular lymphoma

Inès Dufour; Thierry Duprez; Marie Wertz; Pascale Saussoy; Nathalie Ackermans; Souraya El Sankari; Vincent van Pesch; Eric Van Den Neste

doi:10.1002/jha2.56

Improvement in progressive multifocal leukoencephalopathy after pembrolizumab-induced immune reconstruction inflammatory syndrome in a patient with follicular lymphoma

EJHaem. 2020 Oct 23;1(2):585-588. doi: 10.1002/jha2.56. eCollection 2020 Nov.

Authors

Inès Dufour¹, Thierry Duprez², Marie Wertz³, Pascale Saussoy⁴, Nathalie Ackermans⁵, Souraya El Sankari⁵, Vincent van Pesch⁵, Eric Van Den Neste¹

Affiliations

¹ Department of Hematology Université catholique de Louvain, Cliniques universitaires Saint-Luc Brussels Belgium.
² Department of Radiology and Medical Imaging Université catholique de Louvain, Cliniques universitaires Saint-Luc Brussels Belgium.
³ Department of Neurology Clinique Notre-Dame de Grâce Gosselies Belgium.
⁴ Hematology Laboratory Université catholique de Louvain, Cliniques universitaires Saint-Luc Brussels Belgium.
⁵ Department of Neurology Université catholique de Louvain, Cliniques universitaires Saint-Luc Brussels Belgium.

PMID: 35845001
PMCID: PMC9175693
DOI: 10.1002/jha2.56

Abstract

Progressive multifocal leukoencephalopathy (PML) may develop in follicular lymphoma patients treated with bendamustine-rituximab. In this report, treatment with pembrolizumab successfully inhibited the clinical progression of PML by promoting radiologically demonstrated immune restoration inflammatory syndrome (IRIS), allowing complete clearance of the virus. These findings may further support the use of pembrolizumab in PML with special consideration for the potential occurrence of IRIS.

Keywords: Follicular lymphoma; JC virus; immune reconstruction inflammatory syndrome; pembrolizumab; progressive multifocal leukoencephalopathy.

Publication types

Case Reports