PML timing
Posted: Mon Mar 07, 2005 2:34 pm
The following info about the two PML cases associated with T was recently posted in BrainTalk:
Case 1- The person who died had 37 doses of tysabri along with avonex. The last dose was on jan 15, 2005. On Dec. 4 she experienced right-sided weakness and aphasis, which was initially considered an MS relapse. She had two courses of steroids...one on Dec. 4 and one on Jan 5. Symptoms worsened...hospitalized 12 feb....was non-responsive.....etc..etc..etc..subject died 24th of Feb.
Case 2 28 doses of tysabri. Dec. 4th developed slow thinking, slurred speech and cognitive dysfunction, and a left hemiparesis which later progressed to include left-sided sensory impairment in early jan 05. MRI and extensive work-up given...negative Elisa for HIV. Brain biopsy on Feb. 16. Preliminary results of the biopsy on feb. 24 showed a demyelinating process, no vasculitis, no lymphoma, and no evidence of infection or malignancy. Viral PCR testing of the CSF for JC viris is pending. As of Feb. 25, the subject was clinically worsening.
There is something quite remarkable in this. The two PML cases happened very close to each other, almost at the same time - does this sound normal to you ?
You could certainly argue that the two cases had infusions for a long, similar time and that is what caused this timing. But still, seems to be too close and, at the same time, the two patients did have a different # of T infusions.
Any idea why the timing is so close for the two PML cases ?
Thank you
Riccardo
Case 1- The person who died had 37 doses of tysabri along with avonex. The last dose was on jan 15, 2005. On Dec. 4 she experienced right-sided weakness and aphasis, which was initially considered an MS relapse. She had two courses of steroids...one on Dec. 4 and one on Jan 5. Symptoms worsened...hospitalized 12 feb....was non-responsive.....etc..etc..etc..subject died 24th of Feb.
Case 2 28 doses of tysabri. Dec. 4th developed slow thinking, slurred speech and cognitive dysfunction, and a left hemiparesis which later progressed to include left-sided sensory impairment in early jan 05. MRI and extensive work-up given...negative Elisa for HIV. Brain biopsy on Feb. 16. Preliminary results of the biopsy on feb. 24 showed a demyelinating process, no vasculitis, no lymphoma, and no evidence of infection or malignancy. Viral PCR testing of the CSF for JC viris is pending. As of Feb. 25, the subject was clinically worsening.
There is something quite remarkable in this. The two PML cases happened very close to each other, almost at the same time - does this sound normal to you ?
You could certainly argue that the two cases had infusions for a long, similar time and that is what caused this timing. But still, seems to be too close and, at the same time, the two patients did have a different # of T infusions.
Any idea why the timing is so close for the two PML cases ?
Thank you
Riccardo