Progressive Multifocal Leukoencephalopathy After Allogeneic Bone Marrow Transplantation for Acute Myeloid Leukemia

Progressive multifocal leukoencephalopathy (PML) is a rare fatal complication of allogeneic bone marrow transplantation (BMT) resulting from chronic immunosuppression and impaired cellular immunity. This report discusses 2 cases of PML in patients with acute myeloid leukemia after allogeneic BMT. Diagnosis was made based on characteristic brain MRI findings and positive PCR results for John Cunningham virus in the cerebrospinal fluid. Unfortunately, therapeutic options are limited and nearly always result in terminal outcomes. Although immunosuppression is an unavoidable risk of allogeneic BMT, these cases highlight a rare, yet fatal, consequence of prolonged T-cell lymphopenia and impaired cellular immunity after allogeneic BMT in this patient population.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Describe the role of JCV in PML, a rare fatal complication of allogeneic BMT
  • Identify and discuss cancer treatments that have an at-risk patient population for PML
  • Evaluate the potential for PML in the differential diagnosis of any immunocompromised patient who presents with progressive neurologic decline
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
12/12/2014
Course expires: 
12/12/2015
Cost:
$0.00

Hans C. Lee, MD
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas

Victor Mulanovich, MD
Department of Infectious Disease
The University of Texas MD Anderson Cancer Center
Houston, Texas

Yago Nieto, MD, PhD
Department of Stem Cell Transplantation and Cellular Therapy
The University of Texas MD Anderson Cancer Center
Houston, Texas

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
12/12/2014
Course expires: 
12/12/2015

Price

Cost:
$0.00
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  • Adobe Reader or other PDF reader software for article and certificate viewing/printing