PML risk stratification using anti-JCV antibody index and L-selectin.

Details

Serval ID
serval:BIB_773E1C48A078
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
PML risk stratification using anti-JCV antibody index and L-selectin.
Journal
Multiple Sclerosis (houndmills, Basingstoke, England)
Author(s)
Schwab N., Schneider-Hohendorf T., Pignolet B., Spadaro M., Görlich D., Meinl I., Windhagen S., Tackenberg B., Breuer J., Cantó E., Kümpfel T., Hohlfeld R., Siffrin V., Luessi F., Posevitz-Fejfár A., Montalban X., Meuth S.G., Zipp F., Gold R., Du Pasquier R.A., Kleinschnitz C., Jacobi A., Comabella M., Bertolotto A., Brassat D., Wiendl H.
ISSN
1477-0970 (Electronic)
ISSN-L
1352-4585
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Language
english
Notes
Publication types: ARTICLE
Publication Status: aheadofprint
Abstract
BACKGROUND: Natalizumab treatment is associated with progressive multifocal leukoencephalopathy (PML) development. Treatment duration, prior immunosuppressant use, and JCV serostatus are currently used for risk stratification, but PML incidence stays high. Anti-JCV antibody index and L-selectin (CD62L) have been proposed as additional risk stratification parameters.
OBJECTIVE: This study aimed at verifying and integrating both parameters into one algorithm for risk stratification.
METHODS: Multicentric, international cohorts of natalizumab-treated MS patients were assessed for JCV index (1921 control patients and nine pre-PML patients) and CD62L (1410 control patients and 17 pre-PML patients).
RESULTS: CD62L values correlate with JCV serostatus, as well as JCV index values. Low CD62L in natalizumab-treated patients was confirmed and validated as a biomarker for PML risk with the risk factor "CD62L low" increasing a patient's relative risk 55-fold (p < 0.0001). Validation efforts established 86% sensitivity/91% specificity for CD62L and 100% sensitivity/59% specificity for JCV index as predictors of PML. Using both parameters identified 1.9% of natalizumab-treated patients in the reference center as the risk group.
CONCLUSIONS: Both JCV index and CD62L have merit for risk stratification and share a potential biological relationship with implications for general PML etiology. A risk algorithm incorporating both biomarkers could strongly reduce PML incidence.
Pubmed
Create date
02/02/2016 11:10
Last modification date
02/09/2020 5:26
Usage data