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  • Title: CD34+ progenitor cells mobilized by natalizumab are not a relevant reservoir for JC virus.
    Author: Warnke C, Smolianov V, Dehmel T, Andrée M, Hengel H, Zohren F, Arendt G, Wiendl H, Haas R, Hartung HP, Adams O, Kieseier BC.
    Journal: Mult Scler; 2011 Feb; 17(2):151-6. PubMed ID: 21078695.
    Abstract:
    BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is associated with natalizumab treatment in patients with multiple sclerosis (MS). It has been hypothesized that natalizumab mobilizes JC virus (JCV)-infected haematopoietic progenitor cells mediating viraemia and subsequently this disease. OBJECTIVE: The objective of this study was to investigate peripheral haematopoietic progenitor cells for evidence of JCV DNA in MS patients treated with natalizumab. METHODS: We assessed JCV and cytomegalovirus (CMV) DNA in magnetically separated CD34+ haematopoietic progenitor cells, peripheral blood mononuclear cells and plasma of 67 natalizumab-treated patients with MS and six PML patients. RESULTS: Viral DNA was not detectable in CD34+ haematopoietic progenitor or peripheral blood mononuclear cells from any sample. Two plasma samples from patients with MS while undergoing natalizumab treatment were JCV-positive. In one case clinically manifest PML developed 8 months thereafter. CONCLUSIONS: Our findings do not support the hypothesis that natalizumab mobilizes JC virus-infected CD34+ cells from the bone marrow mediating JC viraemia. Notably, JC viraemia was detected in one patient with MS prior to developing clinical PML. This warrants further study.
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