Evidence map›Paper›PMID 34285093›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2021

Combined Treatment With Pembrolizumab and Allogenic BK Virus-Specific T Cells in Progressive Multifocal Leukoencephalopathy: A Case Report.

Rebecca Wicklein, Simon Heidegger, Mareike Verbeek, Britta Eiz-Vesper, Britta Maecker-Kolhoff, Jan Stefan Kirschke, Agata Page, Thomas Korn, Bernhard Hemmer, Marcus Deschauer

Open access · goldAbstract readCase Reports
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. JC Polyomavirus Infection: A Narrative Review.Infectious diseases and therapy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Rebecca WickleinFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany. rebecca.wicklein@tum.de.
Simon HeideggerFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Mareike VerbeekFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Britta Eiz-VesperFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Britta Maecker-KolhoffFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Jan Stefan KirschkeFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Agata PageFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Thomas KornFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Bernhard HemmerFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Marcus DeschauerFrom the Department of Neurology (R.W., T.K., B.H., M.D.), Klinikum rechts der Isar, Technical University Munich; Medical Department III for Hematology and Oncology (S.H., M.V.), Klinikum rechts der Isar, Technical University Munich; Institute for Transfusion Medicine (B.E.-V.), Hannover Medical School; Department of Pediatric Hematology and Oncology (B.M.-K.), Hannover Medical School; Department of Neuroradiology (J.S.K.), Klinikum Rechts der Isar, Technical University Munich; Unilabs A/S (A.P.), Copenhagen, Denmark; Institute of Experimental Neuroimmunology (T.K.), Klinikum rechts der Isar, Technical University of Munich; and Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany.
Klinikum rechts der Isar · DETechnical University of Munich · DEMedizinische Hochschule Hannover · DEMunich Cluster for Systems Neurology · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe report a combination of BK virus-specific T cells and pembrolizumab as a treatment option in progressive multifocal leukoencephalopathy (PML).

resultsA 57-year-old male patient diagnosed with PML presented a fast-progressing right hemiparesis, aphasia, and cognitive deficits. Brain MRI showed a severe leukoencephalopathy with diffusion restriction. The patient was treated with 10 doses of pembrolizumab (2 mg/kg body weight) in differing intervals and 2 partially human leukocyte antigen-matched allogenic BK virus-specific T cell transfusions after the fifth pembrolizumab treatment. Although pembrolizumab alone decreased the viral load but failed to control the virus, BK-specific T cell transfer further enhanced the decline of JC virus copies in the CSF. Moreover, the regression of leukoencephalopathy and disappearance of diffusion restriction in subsequent brain MRI were observed. The combined treatment resulted in a clinical stabilization with improvements of the cognitive and speech deficits. DISCUSSION: This case supports the hypothesis that pembrolizumab is more efficient in the presence of an appropriate number of functional antigen-specific T cells. Thus, the combined treatment of pembrolizumab and virus-specific T cells should be further evaluated as a treatment option for PML in future clinical trials.

Indexed as

Antibodies, Monoclonal, HumanizedBK VirusHumansLeukoencephalopathy, Progressive MultifocalMaleMiddle AgedT-LymphocytesTreatment OutcomeViral LoadAntibodies, Monoclonal, Humanizedpembrolizumab

Identifiers

PMID34285093
PMCPMC8293283
OpenAlexW3187015650

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.