Progressive multifocal leukoencephalopathy developing in a fludarabine naïve patient with chronic lymphocytic leukemia

Melissa G Ooi1, Peter J Kelly2, Michael Farrell3, Philip Murphy4, Peter O’Gorman11Department of Hematology; 2Department of Neurology, Mater Misericordiae Hospital, Dublin, Ireland; 3Department of Neuropathology; 4Department of Hematology, Beaumont Hospital, Dublin, IrelandAbstract: We report a case of progressive multifocal leukoencephalopathy developing in a fludarabine-na ve patient with chronic lymphocytic leukemia. We suggest that progressive multifocal leukoencephalopathy should be considered in any chronic lymphocytic leukemia patient with unexplained neurological symptoms. Treatment history does not necessarily require fludarabine. Intrathecal cytosine arabinoside although unsuccessful in this patient, is a therapeutic option to consider in patients experiencing side effects from systemic therapy.Keywords: progressive multifocal leukoencephalopathy, chronic lymphocytic leukemia, JC virus, fludarabine, intrathecal cytosine arabinoside