title: [Development of cytomegalovirus antigenemia in 3 patients with B cell lymphoma treated with bendamustine monotherapy].
abstract: Bendamustine is one of the new key drugs for patients with indolent lymphoma. Bendamustine, together with rituximab, significantly improves the treatment outcomes of these patients. In addition, previous clinical studies have shown the complication rate of severe infection in bendamustine-containing regimens to be relatively low as compared to those of conventional chemotherapeutic regimens such as CHOP. However, some clinical case reports have raised the possibility that bendamustine may abrogate the immune responses of patients and trigger opportunistic infections including cytomegalovirus reactivation. Herein, we report three indolent lymphoma cases becoming positive on cytomegalovirus antigenemia assay during bendamustine monotherapy. All events occurred after more than three courses of treatment with bendamustine. One patient showed decreased CD4 positive T lymphocytes before the development of cytomegalovirus antigenemia. All three patients were successfully treated with valganciclovir. Although the precise risk is unknown, it should be noted that bendamustine can potentially cause reactivation of/infection with cytomegalovirus and physicians should pay attention to the possibility of this infection during treatment with bendamustine-containing regimens.
authors.affiliation: Department of Hematology and Oncology, University of Yamanashi.
authors.forename: Toru
authors.initials: T
authors.lastname: Mitsumori
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sueki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawashima
authors.forename: Takeo
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yumi
authors.initials: Y
authors.lastname: Nozaki
authors.forename: Kei
authors.initials: K
authors.lastname: Nakajima
authors.forename: Keita
authors.initials: K
authors.lastname: Kirito
mesh_terms: D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D003587:Cytomegalovirus / Q000276:immunology / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009588:Nitrogen Mustard Compounds / Q000008:administration & dosage* / Q000009:adverse effects* / Q000494:pharmacology; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D000077562:Valganciclovir; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000956:Antigens, Viral; D000998:Antiviral Agents; D015415:Biomarkers; D009588:Nitrogen Mustard Compounds; D000069461:Bendamustine Hydrochloride; D000077562:Valganciclovir; D015774:Ganciclovir