Epstein-Barr virus-induced lymphoproliferative disorder after rituximab combined with CHOP therapy.
We present the case of a 35-year-old woman with follicular lymphoma who developed an Epstein-Barr virus (EBV)-induced B-cell lymphoproliferation with secondary viral-induced hemophagocytosis 13 months after treatment with rituximab and CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy. The EBV-induced lymphoproliferation was successfully treated with single-agent rituximab. To our knowledge, this is the first such case reported in the literature. Herein, we briefly review the spectrum of immunodeficiency-associated lymphoproliferative disorders (LPDs), discuss the immune deficit induced by rituximab, and speculate on its possible association with EBV reactivation in this patient.
Johnston
Anna
A
Department of Hematology, Hospices Civils de Lyon and University Claude Bernard, Lyon, France.
Salles
Gilles
G
Espinouse
Daniel
D
Felman
Pascale
P
André
Patrice
P
Berger
Françoise
F
Coiffier
Bertrand
B
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D020031:Epstein-Barr Virus Infections; D005260:Female; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology*; D008224:Lymphoma, Follicular / Q000188:drug therapy*; D008232:Lymphoproliferative Disorders / Q000821:virology*; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage; D014775:Virus Activation
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone