title: Fatal Epstein-Barr virus-associated lymphoproliferative disorder following treatment with a novel mTOR inhibitor for relapsed chronic lymphocytic leukemia leukemia cells.
abstract: We report on a patient with relapsed chronic lymphocytic leukemia (CLL) treated with the novel mTOR inhibitor RAD001 within a phase II clinical trial. Although the patient initially responded to therapy, RAD001 was discontinued after 32 weeks due to progression and fludarabine-based chemotherapy was started. The patient subsequently developed a rapidly fatal Epstein-Barr-virus-associated lymphoproliferative disorder, clonally unrelated to the CLL. The clinical course suggests caution when using newer immunosuppressive drugs for treatment of CLL, especially in the context of additional purine analog therapy.
authors.forename: Katharina S
authors.initials: KS
authors.lastname: Götze
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoffmann
authors.forename: Hermann M
authors.initials: HM
authors.lastname: Schätzl
authors.forename: Christian
authors.initials: C
authors.lastname: Peschel
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.forename: Thomas
authors.initials: T
authors.lastname: Decker
mesh_terms: D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000209:etiology*; D000068338:Everolimus; D017809:Fatal Outcome; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D000081082:Phosphoinositide-3 Kinase Inhibitors; D011494:Protein Kinases; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D058570:TOR Serine-Threonine Kinases; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D000081082:Phosphoinositide-3 Kinase Inhibitors; D000068338:Everolimus; D011494:Protein Kinases; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D014740:Vidarabine; C024352:fludarabine; D020123:Sirolimus