| Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project. | |
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MedLine Citation:
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PMID: 19264918 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Rituximab improves outcomes for persons with lymphoproliferative disorders and is increasingly used to treat immune-mediated illnesses. Recent reports describe 2 patients with systemic lupus erythematosus and 1 with rheumatoid arthritis who developed progressive multifocal leukoencephalopathy (PML) after rituximab treatment. We reviewed PML case descriptions among patients treated with rituximab from the Food and Drug Administration, the manufacturer, physicians, and a literature review from 1997 to 2008. Overall, 52 patients with lymphoproliferative disorders, 2 patients with systemic lupus erythematosus, 1 patient with rheumatoid arthritis, 1 patient with an idiopathic autoimmune pancytopenia, and 1 patient with immune thrombocytopenia developed PML after treatment with rituximab and other agents. Other treatments included hematopoietic stem cell transplantation (7 patients), purine analogs (26 patients), or alkylating agents (39 patients). One patient with an autoimmune hemolytic anemia developed PML after treatment with corticosteroids and rituximab, and 1 patient with an autoimmune pancytopenia developed PML after treatment with corticosteroids, azathioprine, and rituximab. Median time from last rituximab dose to PML diagnosis was 5.5 months. Median time to death after PML diagnosis was 2.0 months. The case-fatality rate was 90%. Awareness is needed of the potential for PML among rituximab-treated persons. |
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Authors:
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Kenneth R Carson; Andrew M Evens; Elizabeth A Richey; Thomas M Habermann; Daniele Focosi; John F Seymour; Jacob Laubach; Susie D Bawn; Leo I Gordon; Jane N Winter; Richard R Furman; Julie M Vose; Andrew D Zelenetz; Ronac Mamtani; Dennis W Raisch; Gary W Dorshimer; Steven T Rosen; Kenji Muro; Numa R Gottardi-Littell; Robert L Talley; Oliver Sartor; David Green; Eugene O Major; Charles L Bennett |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural Date: 2009-03-05 |
Journal Detail:
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Title: Blood Volume: 113 ISSN: 1528-0020 ISO Abbreviation: Blood Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-15 Completed Date: 2009-06-09 Revised Date: 2010-09-22 |
Medline Journal Info:
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Nlm Unique ID: 7603509 Medline TA: Blood Country: United States |
Other Details:
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Languages: eng Pagination: 4834-40 Citation Subset: AIM; IM |
Affiliation:
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Siteman Comprehensive Cancer Center, Washington University School of Medicine, St Louis, MO, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Adverse Drug Reaction Reporting Systems Aged Aged, 80 and over Antibodies, Monoclonal / adverse effects*, therapeutic use Antineoplastic Agents / adverse effects Drug Monitoring / methods Drug Toxicity / epidemiology Female HIV Seronegativity* Humans Leukoencephalopathy, Progressive Multifocal / chemically induced*, epidemiology* Male Middle Aged |
| Grant Support | |
ID/Acronym/Agency:
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1R01 CA125077-01A1/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Antineoplastic Agents; 0/rituximab |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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