Acute development of EBV+ T-cell lymphoproliferative disorder after treatment with rituximab for follicular lymphoma.
Satoko Oka, Yuta Watanabe, Yuina Ueda-Akagi et al.
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Case in brief
An elderly patient developed an EBV-positive T-cell lymphoproliferative disorder (LPD) following treatment with rituximab for follicular lymphoma. The patient exhibited symptoms consistent with hemophagocytic lymphohistiocytosis (HLH), which progressed to clonal T-cell LPD. The case highlights the importance of monitoring EBV load and conducting bone marrow examinations to differentiate between LPD and recurrence of follicular lymphoma.
Diagnostic / clinical pearl
Clinicians should be vigilant for EBV-positive T-cell LPD in patients treated with rituximab, particularly when HLH symptoms arise, as timely diagnosis can lead to life-saving interventions.
Why it matters
This case underscores the potential immunosuppressive effects of rituximab and the need for careful monitoring of EBV in patients undergoing treatment for lymphomas.