Efficacy of recombinant human interleukin 7 in a patient with severe lymphopenia-related progressive multifocal leukoencephalopathy

Jacques Gasnault; Marie-Ghislaine de Goër de Herve; Jean-Marie Michot; Houria Hendel-Chavez; Vannina Seta; Anne-Aurélie Mazet; Thérèse Croughs; Bruno Stankoff; Jean-Henri Bourhis; Olivier Lambotte; Jean-François Delfraissy; Yassine Taoufik

doi:10.1093/ofid/ofu074

Efficacy of recombinant human interleukin 7 in a patient with severe lymphopenia-related progressive multifocal leukoencephalopathy

Open Forum Infect Dis. 2014 Aug 26;1(2):ofu074. doi: 10.1093/ofid/ofu074. eCollection 2014 Sep.

Affiliations

¹ Department of Internal Medicine , Assistance Publique-Hôpitaux de Paris (AP -HP), Hôpital Bicêtre , Le Kremlin-Bicêtre , France ; Institut National de la Santé et de la Recherche Médicale (INSERM) U1012, Faculté de Médecine , Université Paris Sud , Le Kremlin-Bicêtre , France.
² Institut National de la Santé et de la Recherche Médicale (INSERM) U1012, Faculté de Médecine , Université Paris Sud , Le Kremlin-Bicêtre , France.
³ Department of Internal Medicine , Assistance Publique-Hôpitaux de Paris (AP -HP), Hôpital Bicêtre , Le Kremlin-Bicêtre , France ; Department of Haematology , Institut Gustave Roussy , Villejuif , France.
⁴ Department of Internal Medicine , Assistance Publique-Hôpitaux de Paris (AP -HP), Hôpital Bicêtre , Le Kremlin-Bicêtre , France.
⁵ Department of Virology , AP-HP, Hôpital Paul Brousse , Villejuif , France.
⁶ INSERM-Agence Nationale pour la Recherche sur le SIDA , Paris , France.
⁷ Department of Neurology , AP-HP, Hôpital Tenon , Paris , France.
⁸ Department of Haematology , Institut Gustave Roussy , Villejuif , France.
⁹ Department of Internal Medicine , Assistance Publique-Hôpitaux de Paris (AP -HP), Hôpital Bicêtre , Le Kremlin-Bicêtre , France ; Institut National de la Santé et de la Recherche Médicale (INSERM) U1012, Faculté de Médecine , Université Paris Sud , Le Kremlin-Bicêtre , France ; INSERM-Agence Nationale pour la Recherche sur le SIDA , Paris , France.

Abstract

In this study, we report the case of a patient with profound lymphopenia after allogenic bone marrow transplantation who developed severe progressive multifocal leukoencephalopathy. Single-agent recombinant human interleukin-7 therapy was associated with restoration of anti-John Cunningham polyomavirus (JCV) T-cell responses, JCV clearance from cerebrospinal fluid, and a dramatic clinical improvement.

Keywords: JC virus; T-cell lymphopenia; bone marrow transplantation; progressive multifocal leukoencephalopathy; recombinant interleukin-7.