Immune profiling of a patient with alemtuzumab-associated progressive multifocal leukoencephalopathy

Simonetta Gerevini, Ruggero Capra, Diego Bertoli, Alessandra Sottini, Luisa Imberti

Research output: Contribution to journalArticlepeer-review

Abstract

A 31-year-old woman affected by multiple sclerosis (MS) experienced generalized tonic–clonic seizures 2 months after the second alemtuzumab cycle. Positive JC virus (JCV)-DNA in cerebrospinal fluid (CSF) and lesion iconography at magnetic resonance imaging (MRI) were suggestive of progressive multifocal leukoencephalopathy (PML). After 1 month, during full-blown immune reconstitution inflammatory syndrome, JCV-DNA became negative and symptoms gradually improved. New T- and B-cell output and T- and B-cell diversity were low and lymphocytes poorly responded to stimulation. This is the first case of an alemtuzumab-treated patient with clinical symptoms and radiological features compatible with PML. The lack of large T- and B-cell diversity, necessary for JCV recognition, is likely to have concurred to PML insurgence.

Original languageEnglish
Pages (from-to)1196-1201
Number of pages6
JournalMultiple Sclerosis Journal
Volume25
Issue number8
DOIs
Publication statusPublished - Jul 1 2019

Keywords

  • alemtuzumab
  • B-cell receptor repertoire
  • KRECs
  • PML
  • T-cell receptor repertoire
  • TRECs

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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