Journal Article

Clinical and Virological Monitoring During Treatment with Intrathecal Cytarabine in Patients with AIDS-Associated Progressive Multifocal Leukoencephalopathy

Andrea De Luca, Maria Letizia Giancola, Antonella Cingolani, Adriana Ammassari, Laura Gillini, Rita Murri and Andrea Antinori

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 3, pages 624-628
Published in print March 1999 | ISSN: 1058-4838
Published online March 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515153
Clinical and Virological Monitoring During Treatment with Intrathecal Cytarabine in Patients with AIDS-Associated Progressive Multifocal Leukoencephalopathy

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We describe the clinical and virological outcome of human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy (PML) treated with cytarabine. Twentyseven patients received intrathecal cytarabine, 5 received concomitant intravenous cytarabine, and 20 received concomitant antiretroviral therapy. The median baseline CD4+ cell count was 28/mm3. After 4 weeks, 4 (19%) of 21 evaluable patients had stable disease, whereas the others progressed. The median survival from diagnosis and from onset was 66 and 128 days, respectively. Patients with Karnofsky scores of >50 and those previously taking antiretroviral medications had a higher probability of survival 3 months after diagnosis (P = .003 and P = .05, respectively). Overall, after 4 weeks, median JC virus load in CSF increased by 0.7 log10 copies/mL from baseline (P = NS). The mean JC virus load at 4 weeks was lower in patients with stable disease than in progressors (3.47 vs. 4.47 log10 copies/mL; P = .027). JC virus became undetectable in the only patient who had a long-term stable condition. The concentration of JC virus in CSF showed a correlation with clinical outcome.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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