Progressive multifocal leukoencephalopathy (PML) is a devastating disease of the central nervous system caused by JC virus (JCV) infection of oligodendrocytes, often seen in the context of cell-mediated immune compromise. PML was first described in 1958 in a patient with lymphoma, but is now most commonly associated with acquired immune deficiency syndrome (AIDS) and cancer, and increasingly with immune modulatory therapies. Risk stratification for patients beginning immune modulatory therapy is imperfect and can depend on the host immune milieu, biomarkers of JCV in serum, and the therapy to be started. Traditionally treatment of PML was through treatment of underlying immune dysregulation, but more PML-specific therapies have emerged including infusion of interleukins or checkpoint inhibitors and administration of polyoma virus-specific T-cell therapies.

This Research Topic provides an overview of the rapidly developing world of PML, including host-viral interactions, risk stratification for PML development, and developing therapies for the disease. While we aim to emphasize the topics of pre-morbid risk stratification and PML therapeutics, we will look for submissions of a broad range of topics within PML diagnostics and treatment. In particular, we encourage submissions of the following:

- Specific patient populations at risk of developing PML
- Use of biomarkers to stratify pre-morbid risk of PML development in the context
of immune modulatory therapies or other immune suppression.
- Advancements in imaging techniques used for recognition and diagnosis of PML
- Developments in PML therapeutics, including both treatment of underlying
immune suppressive disease as well as therapies aimed specifically at PML
treatment
- Natural history studies or prognosis of PML

The goal of this Research Topic is to bring together international researchers for an update on developments in the realm of PML. Original research articles are encouraged, but reviews and perspective pieces on future directions in the world of PML are also welcome.

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Progressive Multifocal Leukoencephalopathy: From Risk Stratification to Treatment