One case of Progressive Multifocal Leukoencephalopathy Complicating Chronic Myelocytic Leukemia

J Korean Neurol Assoc > Volume 14(1); 1996 > Article

Journal of the Korean Neurological Association 1996;14(1): 282-288.

만성 골수성 백혈병에 합병된 Progressive Multifocal Leukoencephalopathy 1 예

이주헌, 이재흥, 이규헝*

울산대학교 의과대학 서울중앙병원 신경과학교실, 종양내과학교실*

One case of Progressive Multifocal Leukoencephalopathy Complicating Chronic Myelocytic Leukemia

Ju-Hun, Lee. M.D., Jae-Hong, Lee. M.D., Kyoo-Hyung, Lee. M.D.*

Department of Neurology and Oncol*, Ulsan University College of Medicine, Asan Medical Center

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, α-interferon, 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.