Primary Effusion Lymphoma in an HIV-Negative Patient with Chronic Myeloid Leukemia Treated with Dasatinib

Ivo N SahBandar; Chandler B Sy; Tayler van den Akker; David Kim; Julia T Geyer; Amy Chadburn; Ethel Cesarman; Giorgio Inghirami; John N Allan; Momin T Siddiqui; Madhu M Ouseph

doi:10.1159/000530429

Primary Effusion Lymphoma in an HIV-Negative Patient with Chronic Myeloid Leukemia Treated with Dasatinib

Pathobiology. 2023;90(5):356-364. doi: 10.1159/000530429. Epub 2023 Mar 30.

Affiliations

¹ Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA, [email protected].
² Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA.
³ Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, New York, USA.

Abstract

Introduction: Primary effusion lymphoma (PEL) is a malignant lymphomatous effusion, which by definition is Kaposi sarcoma herpesvirus/human herpesvirus 8-positive. PEL typically occurs in HIV-infected patients but can also occur in HIV-negative individuals, including in organ transplant recipients. Tyrosine kinase inhibitors (TKIs) are currently the standard of care for patients with chronic myeloid leukemia (CML), BCR::ABL1-positive. Although TKIs are extremely effective in treating CML, they alter T-cell function by inhibiting peripheral T-cell migration and altering T-cell trafficking and have been associated with the development of pleural effusions.

Case presentation: We report a case of PEL in a young, relatively immunocompetent patient with no history of organ transplant receiving dasatinib for CML, BCR::ABL1-positive.

Discussion: We hypothesize that the loss of T-cell function secondary to TKI therapy (dasatinib) may have resulted in the unchecked cellular proliferation of Kaposi sarcoma herpesvirus (KSHV)-infected cells, leading to the emergence of a PEL. We recommend cytologic investigation and KSHV testing in patients being treated with dasatinib for CML who present with persistent or recurrent effusions.

Keywords: Chronic myeloid leukemia; Dasatinib; Lymphoma; Primary effusion lymphoma.

Publication types

Case Reports

MeSH terms

Dasatinib / adverse effects
HIV Infections* / complications
HIV Infections* / drug therapy
Herpesvirus 8, Human*
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / chemically induced
Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / complications
Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
Lymphoma, Primary Effusion* / chemically induced
Lymphoma, Primary Effusion* / diagnosis
Lymphoma, Primary Effusion* / drug therapy
Sarcoma, Kaposi* / chemically induced

Substances

Dasatinib

Grants and funding

No funding was provided for the preparation of the manuscript.