1. Refractory T-Cell Anergy and Rapidly Fatal Progressive Multifocal Leukoencephalopathy After Prolonged CTLA4 Therapy
- Author
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Manon, Dekeyser, Marie-Ghislaine, de Goër de Herve, Houria, Hendel-Chavez, Céline, Labeyrie, David, Adams, Ghaïdaa Adebs, Nasser, Jacques, Gasnault, Antoine, Durrbach, and Yassine, Taoufik
- Subjects
viruses ,Brief Report ,virus diseases ,transplantation ,JCV-specific T cells ,progressive multifocal leukoencephalopathy - Abstract
Progressive multifocal leukoencephalopathy (PML) is a deadly demyelinating disease due to central nervous system replication of the human polyomavirus JC virus (JCV) in immunosuppressed patients. The only effective therapeutic approach is to restore anti-JCV T-cell responses. In this study, we describe a case of rapidly fatal PML with JCV T-cell anergy in a renal transplant patient treated with CTLA4-Ig (belatacept, a CD28-B7 costimulation blocker and T-cell anergy inducer). T-cell anergy could not be reversed despite several therapeutic approaches. Progressive multifocal leukoencephalopathy secondary to biotherapy-induced T-cell anergy may thus represent a subset of PML with major resistance to anti-JCV immune recovery.
- Published
- 2017