Department of Neurology, Washington University in St. Louis, Box 8111, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA.
Department of Medicine, Washington University in St. Louis, St Louis, MO, USA.
J Neurovirol. 2019 Apr;25(2):284-287. doi: 10.1007/s13365-019-00738-x. Epub 2019 Mar 12.
Therapy for progressive multifocal leukoencephalopathy (PML) remains challenging since there are no antiviral therapies available for JC virus. Immune reconstitution has improved the prognosis in many settings where PML occurs, but it often is not possible in PML patients with hematologic malignancies. We describe the first biopsy proven PML case where the PD-1 inhibitor nivolumab appears to have stimulated immune activation resulting in effective control of PML in a patient with hematologic malignancy. This report supports further investigation of the utility of checkpoint inhibitors for treating PML where other immune reconstitution options are not available.
针对进行性多灶性白质脑病（PML）的治疗仍然具有挑战性，因为目前尚无针对 JC 病毒的抗病毒治疗方法。免疫重建改善了 PML 发生的许多情况下的预后，但在患有血液恶性肿瘤的 PML 患者中通常无法进行免疫重建。我们描述了首例经活检证实的 PML 病例，其中 PD-1 抑制剂纳武单抗似乎刺激了免疫激活，从而使血液恶性肿瘤患者的 PML 得到有效控制。本报告支持进一步研究检查点抑制剂在其他免疫重建方法不可用的情况下治疗 PML 的效用。
