Treatment of Progressive Multifocal Leukoencephalopathy with Nivolumab

A patient with severe idiopathic lymphopenia and progressive multifocal leukoencephalopathy had T-cell exhaustion and high expression of immune checkpoint markers. Treatment with the PD-1 blocker nivolumab led to a reduced CSF JC viral load, stable clinical features, and an immune reconstitution inf...

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Veröffentlicht in:	The New England journal of medicine 2019-04, Vol.380 (17), p.1674-1676
Hauptverfasser:	Walter, Ondine, Treiner, Emmanuel, Bonneville, Fabrice, Mengelle, Catherine, Vergez, François, Lerebours, Fleur, Delobel, Pierre, Liblau, Roland, Martin-Blondel, Guillaume
Format:	Artikel
Sprache:	eng
Schlagworte:	Blood / virology Brain / diagnostic imaging CD4-Positive T-Lymphocytes / physiology CD8-Positive T-Lymphocytes / physiology Cerebrospinal Fluid / virology Immune reconstitution Immunologic Factors / therapeutic use Immunology Inflammation JC Virus / isolation & purification Leukoencephalopathy Leukoencephalopathy, Progressive Multifocal / diagnostic imaging Leukoencephalopathy, Progressive Multifocal / drug therapy Life Sciences Lymphocyte Count Lymphocytes Lymphocytes T Lymphopenia Magnetic Resonance Imaging Microbiology and Parasitology Middle Aged Monoclonal antibodies Nivolumab / therapeutic use NMR Nuclear magnetic resonance Patients PD-1 protein Programmed Cell Death 1 Receptor / antagonists & inhibitors Programmed Cell Death 1 Receptor / metabolism Progressive multifocal leukoencephalopathy Viral Load Virology White Matter / diagnostic imaging White Matter / pathology
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Zusammenfassung:	A patient with severe idiopathic lymphopenia and progressive multifocal leukoencephalopathy had T-cell exhaustion and high expression of immune checkpoint markers. Treatment with the PD-1 blocker nivolumab led to a reduced CSF JC viral load, stable clinical features, and an immune reconstitution inflammatory response on MRI.
ISSN:	0028-4793 1533-4406
DOI:	10.1056/NEJMc1816198