title: Concomitant Epstein-Barr virus-negative large B-cell lymphoma (Richter syndrome) and Epstein-Barr virus- positive B-cell lymphoproliferation after treatment with fludarabine and cyclophosphamide in a patient with B-cell chronic lymphocytic leukemia.
abstract: We report the case of a patient treated with a combination of fludarabine and cyclophosphamide after suffering from B-cell chronic lymphocytic leukemia for 10 years. Three months after treatment, the patient presented with an unusual association, not previously reported in the literature: Richter syndrome (monotypic Epstein-Barr virus- negative large B-cell lymphoma) with the proliferation of Epstein-Barr virus-positive B cells secreting a polytypic immunoglobulin A. The Epstein-Barr virus-positive lymphoproliferation can be accounted for by the type of immunosuppression induced by the treatment.
authors.affiliation: Service d'Anatomie et de Cytologie Pathologiques, Hôtel-Dieu, Paris, France. evacomperat@yahoo.fr
authors.forename: Eva
authors.initials: E
authors.lastname: Compérat
authors.forename: Alain
authors.initials: A
authors.lastname: Delmer
authors.forename: Agnes
authors.initials: A
authors.lastname: Le Tourneau
authors.forename: Thierry J
authors.initials: TJ
authors.lastname: Molina
authors.forename: Jacques
authors.initials: J
authors.lastname: Diebold
authors.forename: Josée
authors.initials: J
authors.lastname: Audouin
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage; D020031:Epstein-Barr Virus Infections / Q000209:etiology* / Q000473:pathology / Q000821:virology; D017809:Fatal Outcome; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D016393:Lymphoma, B-Cell / Q000209:etiology* / Q000473:pathology / Q000821:virology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary; D015275:Tumor Lysis Syndrome / Q000209:etiology* / Q000473:pathology / Q000821:virology; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D007070:Immunoglobulin A; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine