Progressive Multifocal Leukoencephalopathy (PML) in 2 Patients Treated With Elranatamab

IF 2.7 4区医学 Q2 HEMATOLOGY

Clinical Lymphoma, Myeloma & Leukemia Pub Date : 2026-05-01 Epub Date: 2026-02-06 DOI:10.1016/j.clml.2026.01.017

Oliver Tomkins, Rea Grace Maamari, Sam Douthwaite, Amit Roy, Hamish Bain, Neeraj Kohli, Hugues de Lavallade, Majid Kazmi, Sajitha Sachchithanantham, Tracy Dmello, Ella Gault, Matthew Streetly, Dana Warcel

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引用次数: 0

Abstract

•
Clinicians must maintain a high index of suspicion for progressive multifocal leukoencephalopathy (PML) in patients treated with elranatamab who present with neurological symptoms such as ataxia, aphasia, or cognitive changes.
•
A negative initial cerebrospinal fluid PCR for JC virus does not rule out diagnosis, and repeat lumbar puncture is necessary if clinical or radiological suspicion remains high due to limited test sensitivity.
•
Current best practice management involves immediate discontinuation of elranatamab, consideration of plasmapheresis to accelerate drug clearance, and initiation of pembrolizumab to attempt immune restoration.

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2例接受elranatumab治疗的进行性多灶性白质脑病（PML）

•临床医生必须对接受elranatamab治疗的伴有共济失调、失语或认知改变等神经系统症状的进行性多灶性白质脑病（PML）保持高度怀疑。•最初脑脊液PCR检测JC病毒阴性不排除诊断，如果由于检测灵敏度有限，临床或放射学怀疑仍然很高，则需要重复腰椎穿刺。•目前的最佳实践管理包括立即停用elranatamab，考虑血浆置换以加速药物清除，以及开始使用pembrolizumab以尝试免疫恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Lymphoma, Myeloma & Leukemia ONCOLOGY-HEMATOLOGY

CiteScore

2.70

自引率

3.70%

发文量

1606

审稿时长

26 days

期刊介绍： Clinical Lymphoma, Myeloma & Leukemia is a peer-reviewed monthly journal that publishes original articles describing various aspects of clinical and translational research of lymphoma, myeloma and leukemia. Clinical Lymphoma, Myeloma & Leukemia is devoted to articles on detection, diagnosis, prevention, and treatment of lymphoma, myeloma, leukemia and related disorders including macroglobulinemia, amyloidosis, and plasma-cell dyscrasias. The main emphasis is on recent scientific developments in all areas related to lymphoma, myeloma and leukemia. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.