An Epstein-Barr virus-associated leukemic lymphoma in a patient treated with rabbit antithymocyte globulin and cyclosporine for hepatitis-associated aplastic anemia

Acta Haematol. 2012;127(2):96-9. doi: 10.1159/000333609. Epub 2011 Dec 15.

Abstract

Lymphoproliferative disorders (LPDs) are generally caused by uncontrolled B-cell proliferation induced by the Epstein-Barr virus (EBV) in the setting of impaired EBV-specific T-cell immunity, particularly when there is pharmacological immunosuppression including antithymocyte globulin. We herein present an unusual case of EBV associated with LPD (EBV-LPD) in which LPD occurred 3 weeks after the use of rabbit antithymocyte globulin administered for severe hepatitis-associated aplastic anemia; the patient died of fulminant leukemic lymphoma 5 days after the onset. We also review the pertinent literature on EBV-LPD after immunosuppressive therapy and document the efficacy of EBV viral load monitoring and the need for preemptive therapy.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / etiology
  • Anemia, Aplastic / drug therapy
  • Anemia, Aplastic / virology*
  • Animals
  • Antilymphocyte Serum / adverse effects*
  • Antilymphocyte Serum / therapeutic use
  • Cyclosporine / therapeutic use
  • DNA, Viral / blood
  • Epstein-Barr Virus Infections / complications*
  • Fatal Outcome
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / virology*
  • Lymphoproliferative Disorders / virology*
  • Male
  • Middle Aged
  • Rabbits
  • Viral Load

Substances

  • Antilymphocyte Serum
  • DNA, Viral
  • Cyclosporine