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- Title
Refractory T-Cell Anergy and Rapidly Fatal Progressive Multifocal Leukoencephalopathy After Prolonged CTLA4 Therapy.
- Authors
Dekeyser, Manon; de Goër de Herve, Marie-Ghislaine; Hendel-Chavez, Houria; Labeyrie, Célin; Adams, David; Nasser, Ghaïdaa Adebs; Gasnault, Jacques; Durrbach, Antoine; Taoufik, Yassine
- Abstract
rogressive 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
- Subjects
T cells; PROGRESSIVE multifocal leukoencephalopathy; POLYOMAVIRUSES
- Publication
Open Forum Infectious Diseases, 2017, Vol 4, Issue 2, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofx100