Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report
Nivolumab, a monoclonal antibody approved in 2014 as an immune checkpoint inhibitor, offers benefits in cancer treatment but can cause serious neurological complications, including multifocal disseminated necrotizing leukoencephalopathy. We report a case of severe central nervous system toxicity in...
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| Format: | Article |
| Language: | English |
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Korean Encephalitis and Neuroinflammation Society
2025-01-01
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| Series: | Encephalitis |
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| Online Access: | http://encephalitisjournal.org/upload/pdf/encephalitis-2024-00101.pdf |
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| _version_ | 1841550855024672768 |
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| author | Hussein Algahtani Bader Shirah Mohamed Najm Aldeen Alameen Abdulrahman Bin Saeed Alwaleed Abdulhadi Alqahtani |
| author_facet | Hussein Algahtani Bader Shirah Mohamed Najm Aldeen Alameen Abdulrahman Bin Saeed Alwaleed Abdulhadi Alqahtani |
| author_sort | Hussein Algahtani |
| collection | DOAJ |
| description | Nivolumab, a monoclonal antibody approved in 2014 as an immune checkpoint inhibitor, offers benefits in cancer treatment but can cause serious neurological complications, including multifocal disseminated necrotizing leukoencephalopathy. We report a case of severe central nervous system toxicity in a 13-year-old boy with Hodgkin lymphoma who was treated with nivolumab following an inadequate response to multiple lines of chemotherapy. After six cycles of nivolumab, the patient developed multifocal disseminated necrotizing leukoencephalopathy, presenting with altered mental status, seizures, and neurological deficits with magnetic resonance imaging (MRI) findings of extensive white matter involvement, rendering him completely disabled. This case highlights the potential for disabling neurological complications associated with immune checkpoint inhibitors, emphasizing the importance of early detection through regular neurological assessment and MRI surveillance. The case also underscores the need for careful patient selection and monitoring when using nivolumab to mitigate the risk of severe central nervous system toxicity. |
| format | Article |
| id | doaj-art-8138fad6a45f4a5b911b68b50316826c |
| institution | Kabale University |
| issn | 2765-4559 2734-1461 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Encephalitis and Neuroinflammation Society |
| record_format | Article |
| series | Encephalitis |
| spelling | doaj-art-8138fad6a45f4a5b911b68b50316826c2025-01-09T23:24:30ZengKorean Encephalitis and Neuroinflammation SocietyEncephalitis2765-45592734-14612025-01-0151212610.47936/encephalitis.2024.0010177Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case reportHussein Algahtani0Bader Shirah1Mohamed Najm Aldeen Alameen2Abdulrahman Bin Saeed3Alwaleed Abdulhadi Alqahtani4 Neurology Section, Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia Department of Neuroscience, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia Department of Medicine, Khamis Mushayt General Hospital, Khamis Mushait, Saudi Arabia Department of Public Health, Khamis Mushayt General Hospital, Khamis Mushait, Saudi Arabia College of Medicine, Imam Mohammed bin Saud Islamic University, Riyadh, Saudi ArabiaNivolumab, a monoclonal antibody approved in 2014 as an immune checkpoint inhibitor, offers benefits in cancer treatment but can cause serious neurological complications, including multifocal disseminated necrotizing leukoencephalopathy. We report a case of severe central nervous system toxicity in a 13-year-old boy with Hodgkin lymphoma who was treated with nivolumab following an inadequate response to multiple lines of chemotherapy. After six cycles of nivolumab, the patient developed multifocal disseminated necrotizing leukoencephalopathy, presenting with altered mental status, seizures, and neurological deficits with magnetic resonance imaging (MRI) findings of extensive white matter involvement, rendering him completely disabled. This case highlights the potential for disabling neurological complications associated with immune checkpoint inhibitors, emphasizing the importance of early detection through regular neurological assessment and MRI surveillance. The case also underscores the need for careful patient selection and monitoring when using nivolumab to mitigate the risk of severe central nervous system toxicity.http://encephalitisjournal.org/upload/pdf/encephalitis-2024-00101.pdfnivolumabhodgkin lymphomaneurological toxicityimmune checkpoint inhibitorsleukoencephalopathies |
| spellingShingle | Hussein Algahtani Bader Shirah Mohamed Najm Aldeen Alameen Abdulrahman Bin Saeed Alwaleed Abdulhadi Alqahtani Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report Encephalitis nivolumab hodgkin lymphoma neurological toxicity immune checkpoint inhibitors leukoencephalopathies |
| title | Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report |
| title_full | Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report |
| title_fullStr | Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report |
| title_full_unstemmed | Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report |
| title_short | Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report |
| title_sort | multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for hodgkin lymphoma a case report |
| topic | nivolumab hodgkin lymphoma neurological toxicity immune checkpoint inhibitors leukoencephalopathies |
| url | http://encephalitisjournal.org/upload/pdf/encephalitis-2024-00101.pdf |
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