B-Cell-Rich T-Cell Lymphoma Associated with Epstein-Barr Virus-Reactivation and T-Cell Suppression Following Antithymocyte Globulin Therapy in a Patient with Severe Aplastic Anemia.
B-cell lymphoproliferative disorder (B-LPD) is generally characterized by the proliferation of Epstein-Barr virus (EBV)-infected B lymphocytes. We here report the development of EBV-negative B-LPD associated with EBV-reactivation following antithymocyte globulin (ATG) therapy in a patient with aplastic anemia. The molecular autopsy study showed the sparse EBV-infected clonal T cells could be critically involved in the pathogenesis of EBV-negative oligoclonal B-LPD through cytokine amplification and escape from T-cell surveillances attributable to ATG-based immunosuppressive therapy, leading to an extremely rare B-cell-rich T-cell lymphoma. This report helps in elucidating the complex pathophysiology of intractable B-LPD refractory to rituximab.
Department of Hematology/Oncology.
Nobuyoshi
N
Hanaoka
Department of Hematology/Oncology.
Shogo
S
Murata
Department of Hematology/Oncology.
Hiroki
H
Hosoi
First Department of Pathology, Wakayama Medical University , Japan.
Aiko
A
Shimokado
Department of Hematology/Oncology.
Toshiki
T
Mushino
Department of Hematology/Oncology.
Kodai
K
Kuriyama
Department of Hematology/Oncology.
Kazuo
K
Hatanaka
Department of Hematology/Oncology.
Akinori
A
Nishikawa
Department of Hematology/Oncology.
Miwa
M
Kurimoto
Department of Hematology/Oncology.
Takashi
T
Sonoki
First Department of Pathology, Wakayama Medical University , Japan.
Yasuteru
Y
Muragaki
Department of Hematology/Oncology.
Hideki
H
Nakakuma
Epstein-Barr virus; Lymphoproliferative disorder; anti-thymocyte globulin; aplastic anemia; molecular autopsy