Ibrutinib
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Progressive multifocal leukoencephalopathy: case report An approximately 69-year-old woman developed progressive multifocal leukoencephalopathy (PML) during treatment with ibrutinib for mantle cell lymphoma. The woman presented in July 2011 (at the age of 62 years), and was diagnosed with small cell variant of mantle cell lymphoma of the conjunctiva. In August 2018, at approximately 69 years, the mantle cell lymphoma relapsed. She received treatment with ibrutinib [Imbruvica] 560mg per day [route not stated]. Concomitantly, she was receiving various other medications. At 3-weeks follow-up, she complained of vertigo Ibrutinib dose was reduced to 280 mg/day. She developed new neurological symptoms presenting as gait disturbances, muscular weakness and disorientation. Neurological examination revealed disorder of paleocerebellum and signs of left lateral cerebellar dysfunction. In December 2018, she was admitted with left-sided spastic paresis of the upper extremity with following discontinuation of treatment with ibrutinib. MRI was consistent with newly developed hyperintensity changes bilateral on FLAIR and diffusion-weighted image, involving the frontal cortex, and also deep grey matter, without contrast enhancement on T1-weighted image. She received treatment with unspecified vitamins, pulse of immune-globulin and unspecified corticosteroids. However, her condition continued to deteriorate neurologically, progressing into a coma. In February 2019, she died. Autopsy results 48 hours after death confirmed the caused of death to be bilateral asceding bronchopneumonia. Further autopsy findings concluded the final diagnosis of progressive multifocal leukoencephalopathy. Mosna K, et al. Ibrutinib treatment of mantle cell lymphoma complicated by progressive multifocal leukoencephalopathy. International Journal of Clinical Pharmacology and Therapeutics 58: 343-350, No. 6, Jun 2020. Available from: URL: http://doi.org/10.5414/CP203663 803502584
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Reactions 26 Sep 2020 No. 1823
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