Progressive multifocal
leukoencephalopathy (PML)

June 2007     View PDF     En español

How do you treat PML?

Until recently, a diagnosis of PML was quite grim. The one therapy used for treating it, a toxic drug called cytosine arabinoside (ara-C, cytarabine, Cytosar-Ur), is given through a shunt directly into the brain. It has shown marginal, if any, benefit. It is no longer routinely used, though some feel that new drug delivery systems warrant renewed research.

Before the arrival of potent anti-HIV therapy, the average time from diagnosis of PML to death was 1–3 months. Recent studies show that using aggressive anti-HIV therapy may result in an indefinite remission of PML for some people.

Nearly 1 in 10 people with PML have recovered with or without treatment. Spontaneous recovery or stabilization is more likely to occur in people with CD4+ cell counts above 200. The unpredictable nature of this issue presents a perplexing challenge to doctors treating PML.
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