International Journal of Hematology

, Volume 88, Issue 4, pp 434–440 | Cite as

Epstein–Barr virus-associated B-cell lymphoma secondary to FCD-C therapy in patients with peripheral T-cell lymphoma

  • Katja C. Weisel
  • Eckhart Weidmann
  • Ioannis Anagnostopoulos
  • Lothar Kanz
  • Antonio Pezzutto
  • Marion Subklewe
Case Report

Abstract

Epstein–Barr virus (EBV)-associated B-cell lymphoproliferative disorders occur at an increasing frequency in various hereditary and acquired states of immune dysfunction. In a few cases of T-cell lymphoma, especially in angioimmunoblastic T-cell lymphoma (AILT), EBV-associated B-cell lymphoproliferative disorders have been reported. Here, we present two cases of EBV-associated B-cell lymphoma after treatment of T-cell lymphoma (AILT and peripheral T-cell lymphoma, unspecified, PTCL-NOS) with a regimen containing alemtuzumab and fludarabine. Conventional and immunohistological tissue staining showed the typical features of highly proliferating diffuse large B-cell lymphoma in both cases. The monoclonal B-cell population displayed EBV latency type III. At the time of diagnosis the cellular immune status of both patients was severely compromised with an absolute CD4 T-cell count below <120 μl−1. Our observation supports the notion that combination of cytotoxic drugs and immunosuppressive antibodies in patients with T-cell lymphoma may severely aggravate the already present immunodeficiency. We suggest to monitor the cellular immune status in combination with the EBV load in high risk patients for early detection—and possibly intervention—of EBV-associated lymphoma.

Keywords

Epstein–Barr virus Secondary B-cell lymphoma Peripheral T-cell lymphoma AILT Alemtuzumab Fludarabine 

Notes

Acknowledgments

We thank Stefan Kröber for the excellent support in histopathological analyses of case 2.

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Copyright information

© The Japanese Society of Hematology 2008

Authors and Affiliations

  • Katja C. Weisel
    • 1
  • Eckhart Weidmann
    • 2
  • Ioannis Anagnostopoulos
    • 3
  • Lothar Kanz
    • 1
  • Antonio Pezzutto
    • 4
  • Marion Subklewe
    • 4
  1. 1.Department of Hematology, Oncology, Immunology, Rheumatology and Pulmology, Medizinische KlinikUniversitäaetsklinik TübingenTübingenGermany
  2. 2.Klinik für Onkologie und HämatologieKrankenhaus NordwestFrankfurtGermany
  3. 3.Department of PathologyCharité-Universitaetsmedizin BerlinBerlinGermany
  4. 4.Department of Hematology/OncologyCharité-Universitaetsmedizin BerlinBerlinGermany

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