Refereed journal article or data article (A1)
Progressive multifocal leukoencephalopathy in Finland: a cross-sectional registry study
List of Authors: Jussi O. T. Sipilä, Merja Soilu-Hänninen, Päivi Rautava, Ville Kytö
Publisher: Springer Berlin Heidelberg
Publication year: 2019
Journal: Journal of Neurology
Journal acronym: J Neurol
Volume number: 266
Issue number: 2
Start page: 515
End page: 521
Number of pages: 7
ISSN: 0340-5354
eISSN: 1432-1459
DOI: http://dx.doi.org/10.1007/s00415-018-09167-y
URL: https://link.springer.com/article/10.1007/s00415-018-09167-y
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/39288490
OBJECTIVE:To investigate if progressive
multifocal leucoencephalopathy (PML) incidence has increased in Finland
like in the neighbouring Sweden.
METHODS: National
administrative registries were searched for all PML admissions aged
16 years or more in 2004-2014 on all neurological and internal medicine
wards in Finland. The mortality data of the patients was extracted from
the national causes of death registry. National level data on annual
predisposing drug use was obtained from the national pharmaceutical
authority.
RESULTS: We identified 35 PML cases (57% male)
with a peak in 2010-2011 that amounted to 49% of all cases. The annual
incidence for the entire study period was 0.072/100,000 person-years
(95% CI 0.050-0.10) with no temporal trend (p = 0.18). Mean age was
57 years (22-88 years) with no sex difference (p = 0.42). Neoplasms
(60%), HIV infection (17%) and systemic connective tissue disorders
(CTD, 14%) were the most common predisposing conditions. MS was recorded
in three cases (9%). The national level use of drugs that predispose to
PML increased during the study period, with the exceptions of
alemtuzumab and fludarabine. Overall survival was 85% at 90 days, 79% at
1 year, and 66% at 5 years. Survival was worst in patients with
malignancy and best in patients with CTD.
CONCLUSIONS: PML
most often occurs in patients with malignancies and patients with HIV
or CTD cover a third. PML incidence in Finland is lower than in Sweden
and shows no temporal trend despite increasing use of predisposing
drugs. Mortality after PML varies according to the predisposing
condition.
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