{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:33:56Z","timestamp":1773390836040,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 74-year-old woman with a diffuse large B-cell lymphoma was treated with rituximab and CHOP chemotherapy. After three cycles of chemotherapy she developed progressive symptoms of motor imbalance, fatigue, weight loss and impaired cognitive function, which was interpreted as toxicity of the CHOP chemotherapy. The sixth cycle CHOP chemotherapy was withheld and three additional cycles of rituximab were given. Two weeks later, neurological symptoms appeared, including abducens nerve palsy of her left eye, ataxia and hemiparesis of her right body. MRI of the brain revealed two hyperintense lesions on T2-weighted and fluid-attenuated inversion recovery images without oedema or gadolinium enhancement. A PCR on John Cunningham (JC) virus DNA in cerebrospinal fluid was negative, but subsequent brain biopsy diagnosed progressive multifocal leukoencephalopathy (PML). She rapidly deteriorated and died. Awareness of PML during immunosuppressive therapy can be lifesaving, since only immune reconstitution can prevent mortality in these patients.<\/jats:p>","DOI":"10.1136\/bcr-2012-008142","type":"journal-article","created":{"date-parts":[[2013,1,25]],"date-time":"2013-01-25T14:05:42Z","timestamp":1359122742000},"page":"bcr2012008142","source":"Crossref","is-referenced-by-count":16,"title":["Progressive multifocal leukoencephalopathy during treatment with rituximab and CHOP chemotherapy in a patient with a diffuse large B-cell lymphoma"],"prefix":"10.1136","volume":"2013","author":[{"given":"Tineke","family":"Sikkema","sequence":"first","affiliation":[{"name":"Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, Friesland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter Jan","family":"Schuiling","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, Friesland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mels","family":"Hoogendoorn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, Friesland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,1,25]]},"reference":[{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-007-0411-6"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70040-5"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.5414\/NPP26068","article-title":"Progressive multifocal leukoencephalopathy in a lymphoma patient with complete remission after treatment with cytostatics and rituximab: case report and review of the literature","volume":"26","author":"Freim Wahl","year":"2007","journal-title":"Clin Neuropathol"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2010.05.003"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70161-5"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.6","doi-asserted-by":"publisher","DOI":"10.2165\/11537510-000000000-00000"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.7","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1017\/S0317167100012105","article-title":"Monoclonal antibodies and progressive multifocal leukoencephalopathy","volume":"38","author":"Keene","year":"2011","journal-title":"Can J Neurol Sci"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.8","doi-asserted-by":"publisher","DOI":"10.1086\/595299"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-0934(99)00128-7"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-009-0819-2"},{"key":"2025082707213719000_2013.jan25_1.bcr2012008142.11","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-10-186999"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-008142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:21:44Z","timestamp":1756304504000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-008142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,25]]},"references-count":11,"alternative-id":["10.1136\/bcr-2012-008142"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-008142","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,25]]}}}