I have had RRMS since I was about 20 years old. I am now 57 years old and have been told I now have SPMS. I have tried all medications as well as Tysabri last year. My MRI has never ever changed. I have had 7 lesions always. I am also JCV positive. I never had any kinds of major symptoms that interrupted my daily living. In October 2013 I fell and broke my foot. I have never walked again on my own and now I am in a wheelchair. My doctor wants to me to try Rituxan. My question is can I develope PML with the first dose? Thank you for your time.
As you will see from previous blogs and answers to questions, no one develops PML after being off Tysabri for more than 6 months and there is no relationship between JCV antibody testing and risk of PML on Rituximab. In fact the risk of PML in Rituximab treated MS patients appears to be low. Therefore, the answer to your question is, it is very very unlikely (< 1/25,000) you would develop PML after one dose of rituximab based on the information you’ve provided. Other risk factors such as lymphopenia or prior chemotherapy treatment could increase this risk.
Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego