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Case Reports
. 2022 May 20:28:e01514.
doi: 10.1016/j.idcr.2022.e01514. eCollection 2022.

Pembrolizumab for the treatment of Progressive Multifocal Leukoencephalopathy (PML) in a patient with AIDS: A case report and literature review

Tulika Chatterjee  1 , Moni Roy  2 , Rone-Chun Lin  2 , Mohammad O Almoujahed  2 , Sharjeel Ahmad  2
Affiliations
Case Reports

Pembrolizumab for the treatment of Progressive Multifocal Leukoencephalopathy (PML) in a patient with AIDS: A case report and literature review

Tulika Chatterjee et al. IDCases. .

Abstract

Progressive multifocal leukoencephalopathy (PML) is an opportunistic central nervous system (CNS) infection caused by the reactivation of John Cunningham polyomavirus (JCV) from suppression of the host immune system due to conditions such as human immunodeficiency virus causing acquired immunodeficiency syndrome (HIV/AIDS), hematological malignancies, multiple sclerosis, and use of immunosuppressant medications. Pembrolizumab is an immune checkpoint inhibitor targeting programmed cell death protein-1 (PD-1) receptors on lymphocytes. In recent years its use is expanding to treat several malignancies and it is a drug of interest for the treatment of PML. In this case report, we present a case of an HIV/AIDS patient who was given a trial of pembrolizumab for treatment of PML. We also provide a literature review of the reported cases of use of this medication in other immunocompromised states.

Keywords: Pembrolizumab; Pembrolizumab for PML; Pembrolizumab for PML in AIDS; Progressive multifocal leukoencephalopathy (PML).

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Legend: Magnetic resonance image of brain showing confluent increased FLAIR signal intensity involving the subcortical and periventricular white matter and sparing of gray matter of the right parietal-occipital lobes and right temporal lobe.
Fig. 2
Fig. 2
Legend: Follow-up magnetic resonance imaging showing interval progression of foci primarily white matter signal abnormality, involving the right greater than left hemisphere, with involvement of the splenium of the corpus callosum, extension to the parietal occipital white matter.
Fig. 3
Fig. 3
Legend: Follow up magnetic resonance imaging of the brain showing extension of FLAIR signal to the right frontal lobe, temporal lobe, and parietal occipital lobes. Progression of confluence across the midline via the splenium of the corpus callosum with involvement of the left posterior temporal-parietal occipital noted.
See this image and copyright information in PMC

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