Sustained recovery of progressive multifocal leukoencephalopathy after treatment with IL-2

Abstract

Currently, most patients diagnosed with progressive multifocal leukoencephalopathy (PML) are infected with HIV; highly active antiretroviral therapy (HAART) has prolonged the median survival of these patients from 3 months to 1 year.1 Despite encouraging initial case reports, other therapies, including cytosine arabinoside and alpha INF, have been disappointing for both HIV and non-HIV patients with PML.2–4 In addition to the lack of convincing evidence that these treatments alter the natural course of PML, there are concerns of toxicity in patients with low blood counts. Because a plausible biologic basis exists for a role for recombinant interleukin-2 (rIL-2) in the reconstitution of impaired antiviral immune functions, this immunotherapy was administered previously in a patient with PML with apparent success.5 Based on this report, we chose rIL-2 as initial therapy for a patient with myelodysplasia who developed PML. A 58-year-old woman with a 20-year history of myelodysplastic syndrome presented in March 2000 with dysarthria and right hand clumsiness, which developed …