title: Monoclonal Epstein-Barr virus-related lymphoproliferative disorder following adult acute lymphoblastic leukaemia.
abstract: A 31-year-old patient in remission of acute lymphoblastic leukaemia (ALL), receiving oral maintenance chemotherapy (6-mercaptopurine, methotrexate (MTX), cyclophosphamide), developed a monoclonal, Epstein-Barr virus (EBV)-related lymphoproliferative disorder (LPD). Treatment consisted of excisional biopsy and the discontinuation of maintenance chemotherapy. To our knowledge, this is the first such report in an adult. The histological similarity to previous reports of 'lymphomatoid granulomatosis' following paediatric ALL suggests that they are the same disease. MTX may play a central role in the development of LPD in this setting. Although it is a rare complication of ALL, EBV-related LPD should be considered in patients who develop lymphadenopathy.
authors.affiliation: Imperial Cancer Research Fund Medical Oncology Unit, St Bartholomew's Hospital, London. foran@icrf.icnet.uk
authors.forename: J M
authors.initials: JM
authors.lastname: Foran
authors.forename: S E
authors.initials: SE
authors.lastname: Slater
authors.forename: A J
authors.initials: AJ
authors.lastname: Norton
authors.forename: S J
authors.initials: SJ
authors.lastname: Wilkes
authors.forename: I J
authors.initials: IJ
authors.lastname: Hart
authors.forename: A Z
authors.initials: AZ
authors.lastname: Rohatiner
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015321:Gene Rearrangement; D006566:Herpesviridae Infections / Q000150:complications*; D004854:Herpesvirus 4, Human; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000821:virology*; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D014412:Tumor Virus Infections / Q000150:complications*