Natalizumab, multiple sclerosis, and primary central nervous system lymphoma: enigma, wrapped in mystery, enclosed in conundrum.

摘要

It is relatively unusual for a case report to merit editorial comment. The case in point, contributed by Schweikert and colleagues,1 is notable for several reasons. This case documents the first primary central nervous system lymphoma (PCNSL) in a subject receiving natalizumab. As such, it raises scientific and clinical questions. Pertinent issues relate to the possible association of multiple sclerosis (MS) with PCNSL, whether immune modulation with natalizumab could contribute to PCNSL, and how to integrate this case into the risk/benefit calculus for clinicians considering natalizumab therapy for their MS patients.