J Korean Neurol Assoc.  1996 Mar;14(1):282-288.

One case of Progressive Multifocal Leukoencephalopathy Complicating Chronic Myelocytic Leukemia

• Lee JH
• Lee JH
• Lee KH

Abstract

BACKGROUND & SIGNIFICANCE: Progressive multifocal leukoencephalopathy(PML), a rare neurologic disease caused by papovavirus, has been sporadically reported with defective cell-mediated immunity. We report one case of pathologically proven PML complicating chronic myelocytic leukemia(CML). CASE: The patient was a 42-year-old women, who had been diagnosed as CML at age 32 and received autologous bone marrow transplantation 16 months before. She admitted because of progressive memory disturbance and anomic aphasia over several months. Neuropsychological test suggested a left temporal lobe lesion. On T2-weighted brain MR image, there was a diffuse high signal intensity lesion in the left temporal lobe with some mottled enhancement and also in the left corona radiata and deep frontal area. Brain biopsy was done and the JC strain of papovairus was detected by in-situ hybridization technique. Cytarabine, alphainterferon, and acyclovir were tried. About 2 weeks after the medications, significant clinical improvement was noticed. A follow-up MRI 2 month and 6 months later revealed a significant reduction in the extent of the lesion.
CONCLUSION
This is the firsts reported case of pathologically-proven PML in Korea. Unlike the usual PML described in the literature, our patient have showed clinical and radiological improvement in the course of illness.

MeSH Terms

Acyclovir
Adult
Anomia
Biopsy
Bone Marrow Transplantation
Brain
Cytarabine
Female
Follow-Up Studies
Humans
Immunity, Cellular
Korea
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Leukoencephalopathy, Progressive Multifocal*
Magnetic Resonance Imaging
Memory
Neuropsychological Tests
Temporal Lobe
Acyclovir
Cytarabine