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Repisalud author Garrote, Heidys author de la Fuente, Adolfo author Oña, Raquel author Rodríguez, Inmaculada author Echevarria, Juan Emilio author Sepúlveda, Juan M author García, Juan F funder Instituto de Salud Carlos III 2017-09-04T16:36:15Z 2017-09-04T16:36:15Z 2015-03-01 Exp Hematol Oncol. 2015; 4:8 10.1186/s40164-015-0003-4 2162-3619 Experimental Hematology & Oncology 25767742 http://hdl.handle.net/20.500.12105/4861 A 50-year-old male with chronic lymphocytic leukemia (CLL) was treated with fludarabine, cyclophosphamide and rituximab, which produced a complete remission. Eight months after the last dose of rituximab he had visual disturbance, diminished muscular strength in the right arm and vesicular-papular lesions in the left ophthalmic branch region of the V cranial nerve. These were initially interpreted as herpes virus encephalopathy (HVE), but brain magnetic resonance imaging (MRI) showed evidence of demyelination consistent with progressive multifocal leukoencephalopathy (PML). Cerebrospinal fluid (CSF) analysis was negative for varicella zoster virus (VZV) and John Cunningham virus (JCV) DNA. The clinical suggestion of PML prompted us to perform a brain biopsy and to start treatment with mefloquine. In the brain biopsy, histopathological features of demyelination were described and the polymerase chain reaction (PCR) identified JCV, confirming the diagnosis of PML. Treatment with mefloquine (250 mg/week) and dexamethasone (4 mg/day) was started and maintained for 6 months. A year later there was an almost complete resolution of the MRI lesions and the patient achieved a stable clinical state with persisting motor impairment and severe epilepsy. The patient is alive 38 months after diagnosis of PML, which is the longest known survival to date. eng Progressive multifocal leukoencephalopathy John Cunningham virus Demyelization Immune system suppression Long-term survival in a patient with progressive multifocal leukoencephalopathy after therapy with rituximab, fludarabine and cyclophosphamide for chronic lymphocytic leukemia research article URL https://repisalud.isciii.es/bitstreams/a869f499-6328-47e9-88e7-ab8f03213a1f/download File MD5 0d054817558f313a7f90239d4fe26af6 1060855 application/pdf Long-termSsurvivalInAPatient_2015 URL https://repisalud.isciii.es/bitstreams/6c822383-da9f-450f-ae1e-d7c48b96cbda/download File MD5 50c0707f929ca574e6491ac5d5983f0c 17922 text/plain 40164_2015_Article_3.pdf.txt URL https://repisalud.isciii.es/bitstreams/4014b2e9-2d50-4e00-9115-b73c38e725a8/download File MD5 0fdb1c85d97121be70aa578851d7dff8 17913 text/plain Long-termSsurvivalInAPatient_2015.txt