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Case Rep Oncol. 2011 Jan;4(1):136-42. doi: 10.1159/000326851. Epub 2011 Mar 12.

Progressive Multifocal Leukoencephalopathy in a HIV-Negative Patient with Small Lymphocytic Leukemia following Treatment with Rituximab.

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Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebr., USA.


We describe a case of progressive multifocal leukoencephalopathy (PML) caused by infection with the human polyomavirus JC virus in a patient with B-cell small lymphocytic leukemia who was treated with rituximab. The first symptoms of PML appeared immediately following the last of five cycles of rituximab, cyclophosphamide and pentostatin. Magnetic resonance imaging revealed changes consistent with PML, although JC virus DNA was not detected by polymerase chain reaction assay of the cerebrospinal fluid. A stereotactic biopsy of the brain showed histological changes consistent with PML, while electron microscopy revealed JC virus particles attached to the nuclei of astrocytes. The patient was treated supportively but died 53 days after the initial onset of symptoms.


JC virus; Progressive multifocal leukoencephalopathy; Rituximab; Small lymphocytic leukemia

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