Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports
Progressive multifocal leukoencephalopathy (PML) is a life-threatening central nervous system condition caused by reactivation of JC virus in individuals with immunosuppression. Although PML typically develops in patients with human immunodeficiency virus (HIV), cases in individuals without HIV have...
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Elsevier
2025-09-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225001742 |
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| author | Hanako Aoki Ryunosuke Matsumura Yoichiro Nishida Kazuo Nakamichi Takanori Yokota Nobuo Sanjo |
| author_facet | Hanako Aoki Ryunosuke Matsumura Yoichiro Nishida Kazuo Nakamichi Takanori Yokota Nobuo Sanjo |
| author_sort | Hanako Aoki |
| collection | DOAJ |
| description | Progressive multifocal leukoencephalopathy (PML) is a life-threatening central nervous system condition caused by reactivation of JC virus in individuals with immunosuppression. Although PML typically develops in patients with human immunodeficiency virus (HIV), cases in individuals without HIV have been increasing in recent years. Non-HIV–associated PML has a particularly poor prognosis, high mortality rates, and few therapeutic options. Here, we present the cases of two patients with non-HIV–, nondrug–associated PML who achieved good clinical outcomes after treatment with filgrastim (granulocyte colony-stimulating factor [G-CSF]). One patient had a diagnosis of Good syndrome, a rare primary immunodeficiency disease, whereas the other presented with lymphopenia and a mild decrease in CD4 T cells. After G-CSF administration, both patients showed decreases in CSF JC virus loads and improvements on magnetic resonance images. Given these findings, we propose that, by stimulating innate immunity and activating anti-JC viral immune surveillance, G-CSF may be useful as an immune-enhancing therapy for patients with non-HIV–associated PML. |
| format | Article |
| id | doaj-art-37e58a6e7cb84bf8bc90cb57cae478ed |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-37e58a6e7cb84bf8bc90cb57cae478ed2025-08-20T03:18:38ZengElsevierInternational Journal of Infectious Diseases1201-97122025-09-0115810795010.1016/j.ijid.2025.107950Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reportsHanako Aoki0Ryunosuke Matsumura1Yoichiro Nishida2Kazuo Nakamichi3Takanori Yokota4Nobuo Sanjo5Department of Neurology and Neurological Science, Institute of Science Tokyo hospital, Tokyo, Japan; Corresponding author. Hanako Aoki, Department of Neurology and Neurological Science, Institute of Science Tokyo hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.Department of Neurology and Neurological Science, Institute of Science Tokyo hospital, Tokyo, JapanDepartment of Neurology and Neurological Science, Institute of Science Tokyo hospital, Tokyo, JapanDepartment of Virology 1, National Institute of Infectious Diseases, Tokyo, JapanDepartment of Neurology and Neurological Science, Institute of Science Tokyo hospital, Tokyo, JapanDepartment of Neurology and Neurological Science, Institute of Science Tokyo hospital, Tokyo, Japan; Department of Internal Medicine, Division of Neurology, Kudanzaka Hospital, Tokyo JapanProgressive multifocal leukoencephalopathy (PML) is a life-threatening central nervous system condition caused by reactivation of JC virus in individuals with immunosuppression. Although PML typically develops in patients with human immunodeficiency virus (HIV), cases in individuals without HIV have been increasing in recent years. Non-HIV–associated PML has a particularly poor prognosis, high mortality rates, and few therapeutic options. Here, we present the cases of two patients with non-HIV–, nondrug–associated PML who achieved good clinical outcomes after treatment with filgrastim (granulocyte colony-stimulating factor [G-CSF]). One patient had a diagnosis of Good syndrome, a rare primary immunodeficiency disease, whereas the other presented with lymphopenia and a mild decrease in CD4 T cells. After G-CSF administration, both patients showed decreases in CSF JC virus loads and improvements on magnetic resonance images. Given these findings, we propose that, by stimulating innate immunity and activating anti-JC viral immune surveillance, G-CSF may be useful as an immune-enhancing therapy for patients with non-HIV–associated PML.http://www.sciencedirect.com/science/article/pii/S1201971225001742FilgrastimG-CSFJC virusProgressive multifocal leukoencephalopathy |
| spellingShingle | Hanako Aoki Ryunosuke Matsumura Yoichiro Nishida Kazuo Nakamichi Takanori Yokota Nobuo Sanjo Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports International Journal of Infectious Diseases Filgrastim G-CSF JC virus Progressive multifocal leukoencephalopathy |
| title | Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports |
| title_full | Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports |
| title_fullStr | Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports |
| title_full_unstemmed | Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports |
| title_short | Efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy: Two case reports |
| title_sort | efficacy of filgrastim therapy for patients with progressive multifocal leukoencephalopathy two case reports |
| topic | Filgrastim G-CSF JC virus Progressive multifocal leukoencephalopathy |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225001742 |
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