NHS Fife, Haematology, Victoria Hospital, Kirkcaldy, KY2 5AH, UK.
Ann Hematol. 2021 Jan;100(1):1-10. doi: 10.1007/s00277-020-04294-x. Epub 2020 Oct 3.
Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection with high mortality rate usually seen in the context of immunosuppression. Although cases have been reported largely in patients with HIV/AIDS, following the use of monoclonal antibodies and occasionally in haematological malignancies, there is no review to date of patients with smouldering or treated myeloma who developed PML. Here, we conducted a literature search of PML cases in patients with multiple myeloma (MM), analyse patient and disease characteristics and describe the possible mechanisms that could lead to the development of PML. The lack of data and case reports until 2010 may indicate that PML in MM is underdiagnosed. Simultaneously, with an expanding field of new therapeutic options, patients with MM live longer, albeit continually immunosuppressed, and at risk of opportunistic infections. Emerging new treatments for PML in the horizon render the need to look out for this complication mandatory, and more case reports are needed to enrich our knowledge in this field.
进行性多灶性白质脑病（PML）是一种罕见的机会性感染，通常在免疫抑制的情况下发生，死亡率较高。虽然大多数病例发生在 HIV/AIDS 患者中，但在使用单克隆抗体后，偶尔也会发生在血液恶性肿瘤患者中，但目前尚无关于冒烟型或治疗后多发性骨髓瘤患者发生 PML 的综述。在这里，我们对多发性骨髓瘤（MM）患者中的 PML 病例进行了文献检索，分析了患者和疾病特征，并描述了可能导致 PML 发展的潜在机制。直到 2010 年缺乏数据和病例报告可能表明 MM 中的 PML 诊断不足。同时，随着新治疗选择领域的不断扩大，MM 患者的寿命更长，尽管持续免疫抑制，但仍有机会发生感染。新兴的 PML 治疗方法使得必须寻找这种并发症，并且需要更多的病例报告来丰富我们在这一领域的知识。
