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Risk Factors

PML is likely caused by a combination of factors. Risk factors include the presence of pathogenic JCV and an altered or weakened immune system; they may also include genetic or environmental risk factors.
 

PML Risk Factors Diagram

 

For patients currently being treated with certain immunomodulatory therapies, prior use of other immunosuppressant drugs is also a risk factor for PML development.6

 

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1 Carl E. Reid et. al. Sequencing and Analysis of JC Virus DNA From Natalizumab-Treated PML Patients. J Infect Dis. 2011 July 15; 204(2): 237–244.

2 Egli A, Infanti L, et.al. Prevalence of polyomavirus BK and JC infection and replication in 400 healthy blood donors. J Infect Dis. 2009 Mar 15, 199(6): 837-46.

3 Gorelik L et. al. Anti-JC virus antibodies: implications for PML risk stratification. Ann Neurol 2010 Sep;68(3): 295-303.

3 Bloomgren G et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N Engl J Med. 2012 May 17;366(20):1870-80.

4 Gorelik L et. al. Anti-JC virus antibodies: implications for PML risk stratification. Ann Neurol 2010 Sep;68(3): 295-303.

5MedlinePlus. Progressive Multifocal Leukoencephalopathy. http://www.nlm.nih.gov/medlineplus/ency/article/000674.htm. Updated February 16, 2012. Accessed September 2012.

6 Clifford DB. et. al. Natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: lessons from 28 cases. Lancet Neurol. 2010 9, 438-446