Table 1.
Case reports of use of IL-2 therapy for management of PML.
| Age (years)/sex | Clinical presentation | MRI findings | Dose | Duration of therapy | Underlying predisposing factor | JCV CSF PCR/brain biopsy | Improvement in neurological status | |
|---|---|---|---|---|---|---|---|---|
| Dubey et al.(in press) | 51/F | Global aphasia, right sided neglect, right hemiparesis, complex partial seizure | Left frontoparietal and right parietal lesions hyperintense on T2-WI and mild contrast enhancement | IL-2: 50,000 units/m2 initial dose, then 1 million units/m2 daily, SQ | 84 days | Natalizumab therapy for RRMS | + | Decrease in JCV quantitative PCR, improvement and stabilization of neurological status |
| Methylprednisone: 1 g weekly | ||||||||
| Buckanovich et al. [2002] | 29/F | Ataxic, decreased, visual acuity, bilateral inferior,visual field deficits | Irregular diffuse noncontrast enhancing lesions in bilateral parietal lobes, hyperintese on T2-WI | IL-2: 0.5 million units/m2 per day, IV | 116 days, followed reinitiation of therapy 20 days later, duration of therapy NS | Hodgkin’s lymphoma treated with NMASCT | _ | Neurological deficits completely resolved; patient able to perform all activities of daily living |
| status post radiation therapy, | ||||||||
| MOPP/ABV chemotherapy, cyclosporiene for GVHD prophylaxis | ||||||||
| Kunschner and Scott [2005] | 58/F | Cognitive deterioration, dysarthria, right hemiparesis | Irregular no contrast enhancing 3–4 cm lesion in the left centrum semiovale, hyper-intense on T2-WI | IL-2: 0.5 million units /m2 per day for 5 weeks, 1.0 million units /m2 per day for a sixth week, IV | 42 days | Myelodysplastic syndrome | + | 5-year follow up |
| Improved cognition, mild dysarthria, and moderate right hemiparesis | ||||||||
| Przepiorka et al. [1997] | 46/F | Vertigo, aphasia and right hemiparesis | Contrast nonenhancing T2 hyperintense lesion in left frontoparietal region | IL-2: 0.5 million units/m2 per day, IV | 182 days | Low-grade lymphoma status post etoposide, cyclophosphamide, total body irradiation, and autologous marrow and blood stem cell transplantation | + | Improvement in speech and motor function |
ABV, doxorubicin, bleomycin, vinblastine chemotherapy; CSF, cerebrospinal fluid; GVHD, graft-versus-host disease; IL-2, interleukin-2; IV, intravenous; JCV, John Cunningham virus; MOPP, mechlorethamine, vincristine, procarbazine; MRI, magnetic resonance imaging; PCR, polymerase chain reaction; NMASCT, nonmyeloablative allogeneic stem cell transplantation; PML, progressive multifocal leukoencephalopathy; RRMS, relapsing–remitting multiple sclerosis; SQ, subcutaneous; T2-WI, T2-weighted images.