Table 1. Clinical Characteristics of PML Cases Following Transplantation from 4 Academic Medical Centers.
Case Number | Age/Sex | Underlying Diagnosis | Transplantation Type | Presenting Features | Time to PML Symptom Onset from Transplantation (mo) | Time to Diagnosis from Symptom Onset (mo) | Method of Diagnosis | Survival Following PML Diagnosis (mo) |
---|---|---|---|---|---|---|---|---|
1 | 42/F | Hepatitis C, alcohol abuse | Liver | HA, hand clumsiness, dysarthria | 1 | 2 | CSF | Still alive (155+) |
2 | 50/M | Mantle cell lymphoma | Bone marrow | Irritability, memory loss, tremors | 14 | 9 | Suspected | 34 |
3 | 56/F | Cryptogenic cirrhosis | Liver | Cortical blindness, seizures, hemiparesis | <1a | 9 | Autopsy | 9 |
4 | 47/M | Histiocytosis X | Lung | Encephalopathy | 63 | 1 | Suspected | 64 |
5 | 47/F | Amyloidosis | Heart | Cortical blindness | 15 | 3 | Brain biopsyb | 13 |
6 | 64/M | Dilated cardiomyopathy | Heart | Encephalopathy | 55 | 1 | Suspected | 43 |
7 | 39/F | Idiopathic pulmonary fibrosis | Lung | Ataxia | 42 | 3 | CSF | 51 |
8 | 68/M | Cryptogenic cirrhosis | Liver | Hemiparesis | 8 | <1 | CSF | 9 |
9 | 56/F | Hepatitis C | Liver | Hemiparesis, hemianesthesia | 116 | 8 | CSF | 124 |
10 | 68/M | Chronic lymphocytic leukemia transformed to B-cell lymphoma | Bone Marrow | Ataxia, aphasia | 3 | 1 | CSF, brain biopsy | 5 |
11 | 55/M | Chronic membranous nephropathy | Kidney | Ataxia, dysarthria | 32 | 2 | CSF | 34 |
12 | 62/F | Chronic obstructive pulmonary disease | Bilateral lung | Memory loss, ataxia, falls | 27 | <1 | CSF | 16 |
13 | 45/M | Hypertensive nephropathy | Kidney | Cognitive slowing, hemiparesis | 202 | 1 | CSF | 204 |
14 | 43/M | Acute myeloid leukemia | Bone marrow | Diplopia | 20 | 1 | CSF | Still alive (44+) |
15 | 40/M | Focal segmental glomerulosclerosis | Kidney | Monoparesis | 48 | 12 | CSF | Still alive (13+) |
Patient was diagnosed with PRES in life; symptoms may have represented PRES or PML.
CSF PCR negative for JC virus in life.
CSF = cerebrospinal fluid; HA = headache; PCR = polymerase chain reaction; PML = progressive multifocal leukoencephalopathy; PRES = posterior reversible encephalopathy syndrome.