Progressive Multifocal Leukoencephalopathy Among Ibrutinib Treatment In Chronic Lymphocytic Leukemia

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dc.contributor.authorÇetintepe T.
dc.contributor.authorGediz F.
dc.contributor.authorAkyar I.
dc.contributor.authorÇetintepe L.
dc.contributor.authorKoç A.M.
dc.date.accessioned2024-07-22T08:04:19Z
dc.date.available2024-07-22T08:04:19Z
dc.date.issued2022
dc.description.abstractIntroduction: Both chronic lymphocytic leukemia (CLL) itself and the drugs used for its treatment, pose a risk for progressive multifocal leukoencephalopathy (PML). Although the relationship between Rituximab and PML is well known, case reports that have been recently published, suggest that ibrutinib; which is used in the treatment of CLL, may increase the risk of PML. Case report: Here, we report a case of 64 year-old female patient with CLL who was previously treated with rituximab, fludarabine and bendamustin but developed PML after receiving monotherapy with ibrutinib. According to Naranjo’s algorithm, the causality relationship with the drug is possible with a score of 3. The patient initially exhibited neurological symptoms. Magnetic resonance of the brain revealed a bilateral asymmetric hyperintensity in the white matter involving the parietal and occipital lobules, and there was no mass effect, edema, hemorrhagic or iscemic lesions. No enhancement of contrast media was observed. The findings were consistent with demyelination and suggestive of PML. Management and outcome: Mirtazapine treatment was initiated. However, neurological sympthoms continuously progressed over the following weeks and the patient, aged 64, died six weeks after diagnosis of PML. Discussion: PML is a rare and often fatal demyelinating disease of the central nervous system (CNS) that is exclusively seen in immunocompromised patients and there is no specific agent to treat PML. The case discussed here, highlights that the use of ibrutinib in chronic lymphocytic leukemia (CLL) therapy may result in PML. © The Author(s) 2022.
dc.identifier.DOI-ID10.1177/10781552221074281
dc.identifier.issn10781552
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/12659
dc.language.isoEnglish
dc.publisherSAGE Publications Ltd
dc.subjectBrain
dc.subjectFemale
dc.subjectHumans
dc.subjectLeukemia, Lymphocytic, Chronic, B-Cell
dc.subjectLeukoencephalopathy, Progressive Multifocal
dc.subjectMiddle Aged
dc.subjectRituximab
dc.subjectbendamustine
dc.subjectCD19 antigen
dc.subjectCD20 antigen
dc.subjectCD22 antigen
dc.subjectCD23 antigen
dc.subjectCD5 antigen
dc.subjectchlorambucil
dc.subjectcontrast medium
dc.subjectcyclophosphamide
dc.subjectdexamethasone
dc.subjectepirubicin
dc.subjectfludarabine
dc.subjectibrutinib
dc.subjectlenalidomide
dc.subjectmirtazapine
dc.subjectmitoxantrone
dc.subjectofatumumab
dc.subjectpentostatin
dc.subjectprednisolone
dc.subjectrituximab
dc.subjectibrutinib
dc.subjectrituximab
dc.subjectadult
dc.subjectArticle
dc.subjectaspiration pneumonia
dc.subjectbody weight loss
dc.subjectbrain
dc.subjectcancer staging
dc.subjectcase report
dc.subjectcerebrospinal fluid analysis
dc.subjectcervical lymphadenopathy
dc.subjectchronic lymphatic leukemia
dc.subjectclinical article
dc.subjectclinical feature
dc.subjectdemyelination
dc.subjectdepression
dc.subjectdrug withdrawal
dc.subjectdysarthria
dc.subjectfatality
dc.subjectfemale
dc.subjectflow cytometry
dc.subjectfluid-attenuated inversion recovery imaging
dc.subjecthuman
dc.subjecthuman cell
dc.subjectJC virus
dc.subjectlumbar puncture
dc.subjectmiddle aged
dc.subjectmonotherapy
dc.subjectmultiple cycle treatment
dc.subjectnervousness
dc.subjectneurologic disease
dc.subjectnight sweat
dc.subjectnuclear magnetic resonance imaging
dc.subjectoccipital lobe
dc.subjectparaaortic lymph node
dc.subjectparesis
dc.subjectparietal lobe
dc.subjectpersonality disorder
dc.subjectpolymerase chain reaction
dc.subjectprogressive multifocal leukoencephalopathy
dc.subjectrecurrent infection
dc.subjectsplenomegaly
dc.subjectT2 weighted imaging
dc.subjectwhite matter lesion
dc.subjectchronic lymphatic leukemia
dc.subjectpathology
dc.subjectprogressive multifocal leukoencephalopathy
dc.titleProgressive Multifocal Leukoencephalopathy Among Ibrutinib Treatment In Chronic Lymphocytic Leukemia
dc.typeArticle

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