Sano Yasuteru, Nakano Yuta, Omoto Masatoshi, Takao Masaki, Ikeda Eiji, Oga Atsunori, Nakamichi Kazuo, Saijo Masayuki, Maoka Takashi, Sano Hironori, Kawai Motoharu, Kanda Takashi
Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Japan.
Intern Med. 2015;54(8):965-70. doi: 10.2169/internalmedicine.54.2308. Epub 2015 Apr 15.
A 66-year-old man with non-Hodgkin lymphoma (NHL) developed progressive multifocal leukoencephalopathy (PML) after undergoing chemotherapy including rituximab. Although the administration of mefloquine at a dose of 500 mg weekly temporarily led to a dramatic decrease in the copy number of JC Virus DNA in the cerebrospinal fluid, the patient's symptoms gradually worsened. The CD4(+) T count remained continuously low, at least until approximately five months after the last cycle of chemotherapy. A postmortem examination performed 10 months after the onset of PML disclosed a severe condition associated with rituximab-treated PML originating from NHL and a high mefloquine concentration in the brain. The accumulation of further data regarding mefloquine treatment in PML cases may help to elucidate the optimal dosage and time window for effectively treating PML.
一名66岁的非霍奇金淋巴瘤（NHL）男性患者在接受包括利妥昔单抗在内的化疗后发生了进行性多灶性白质脑病（PML）。尽管每周服用500毫克甲氟喹可使脑脊液中JC病毒DNA拷贝数暂时大幅下降，但患者症状仍逐渐恶化。CD4(+) T细胞计数持续偏低，至少持续到化疗最后一个周期后约五个月。PML发病10个月后进行的尸检显示，病情严重，与NHL来源的利妥昔单抗治疗的PML相关，且大脑中甲氟喹浓度较高。关于甲氟喹治疗PML病例的更多数据积累可能有助于阐明有效治疗PML的最佳剂量和时间窗。
