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Journal Articles Annals of Neurology Year : 2022

Outcome of Progressive Multifocal Leukoencephalopathy Treated by Interleukin‐7

Andrea Tarantino
  • Function : Author
Alexa Debard
  • Function : Author
Pierre Delobel
  • Function : Author
Nathalie Pansu
  • Function : Author
Cédric Gollion
  • Function : Author
Marie Benaiteau
  • Function : Author
Christine Jacomet
  • Function : Author
Nicolas Mélé
  • Function : Author
Antoine Moulignier
  • Function : Author
Felipe Suarez
  • Function : Author
Yvon Ruch
  • Function : Author
Christine Tranchant
  • Function : Author
Adrien Lemaignen
  • Function : Author
Sophie Langner-Lemercier
  • Function : Author
Rodolphe Buzele
  • Function : Author
Aurelien Guffroy
  • Function : Author
Cécile Moluçon-Chabrot
  • Function : Author
Giovanna Melica
  • Function : Author
Carmen‐ionela Badiu
  • Function : Author
Chrystel Cheraud-Bonfort
  • Function : Author
Anne Salmon
  • Function : Author
Karl Bjornar Alstadhaug
  • Function : Author
F. Matthew Kuhlmann
  • Function : Author
Lucas Gorza
  • Function : Author
Adrien Wang
  • Function : Author
Heidi Wille
  • Function : Author
Elodie Curlier
  • Function : Author
Mojgan Hessamfar
  • Function : Author
Florent Valour
  • Function : Author
Thomas Perpoint
  • Function : Author
Igor Koralnik
  • Function : Author
Kevin Decaestecker
  • Function : Author
William Vindrios
  • Function : Author
Anne Guilbert
  • Function : Author
Jean Marc Boulesteix
  • Function : Author
Sylvie Colin De Verdière
  • Function : Author
Antoine Roux
  • Function : Author
Amila Patel
  • Function : Author
Michelle Fabian
  • Function : Author
Asaff Harel
  • Function : Author
Benjamin Wyplosz
  • Function : Author
Florence Ader
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Abstract

Objective: Restoring anti-JC virus (JCV) immunity is the only treatment of progressive multifocal leukoencephalopathy (PML). Interleukin-7 is a cytokine that increases number and function of T cells. We analyzed a population of PML patients who received recombinant human IL-7 (rhIL-7) to estimate survival and its determinants. Methods: After exclusion of patients with missing data or receiving other immunotherapies, findings from 64 patients with proven PML who received rhIL-7 between 2007 and 2020 were retrospectively analyzed. Logistic regression was used to analyze variables associated with one-year survival. Results: Underlying conditions were HIV/AIDS (n = 27, 42%), hematological malignancies (n = 16, 25%), primary immunodeficiencies (n = 13, 20%), solid organ transplantation (n = 4, 6%) and chronic inflammatory diseases (n = 4, 6%). One-year survival was 54.7% and did not differ by underlying condition. Survival was not associated with baseline characteristics, but with a >50% increase in blood lymphocytes (OR 4.1, 95%CI 1.2-14.9) and CD4+ T cells (OR 5.9, 95%CI 1.7-23.3), and a > 1 log copies/mL decrease in cerebrospinal fluid JCV DNA (OR 7.6, 95%CI 1.6-56.1) during the first month after rhIL-7 initiation. Side effects were mainly local and flu-like symptoms (n = 8, 12.5%) and PML-immune reconstitution inflammatory syndrome (IRIS) (n = 5, 8%). Interpretation: In this non-controlled retrospective study, survival did not differ from that expected in HIV/AIDS patients, but might have been improved in those with hematological malignancies, primary immunodeficiencies and transplant recipients. RhIL-7 might have contributed to the increase in blood lymphocytes and decrease in CSF JCV replication that were associated with better survival. ANN NEUROL 2022;91:496-505.

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Cancer
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Dates and versions

hal-03780669 , version 1 (19-09-2022)

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Rébecca Lajaunie, Ilaria Mainardi, Jacques Gasnault, Vanessa Rousseau, Andrea Tarantino, et al.. Outcome of Progressive Multifocal Leukoencephalopathy Treated by Interleukin‐7. Annals of Neurology, 2022, 91 (4), pp.496-505. ⟨10.1002/ana.26307⟩. ⟨hal-03780669⟩
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