Epstein–Barr Virus Load Correlating with Clinical Manifestation and Treatment Response in a Patient with Angioimmunoblastic T-Cell Lymphoma
Epstein–Barr Virus Load Correlating with Clinical Manifestation and Treatment Response in a Patient with Angioimmunoblastic T-Cell Lymphoma
复制标题
EB 病毒载量与血管免疫母细胞 T 细胞淋巴瘤患者的临床表现和治疗反应相关
作者：
M. Battegay;C. Berger;C. Rochlitz;N. Hurwitz;H. Hirsch;C. Geyter;T. Haque;D. Nadal
EB病毒相关性淋巴瘤可能继发于血管免疫母细胞性T细胞淋巴瘤。尽管进行了化疗和实验性治疗，但预后很差。我们报告一位40岁的女性，患有AITL，没有明显的免疫缺陷，发展为EBV相关淋巴瘤。淋巴结肿大的发生和大小与血清EBV载量(EBVL)密切相关。早期应用万乃洛韦治疗，EBVL下降3log10以上，完全缓解。然而，万乃洛韦在6个月后因副作用而不得不停药，3个月后随着EBVL的增加而复发。最终开始细胞毒性化疗和抗CD20治疗只导致部分缓解。淋巴瘤病情恶化，确诊33个月后死亡。这一病例报告证明了EBVL和AITL之间的密切联系，以及在疾病表现的初始阶段进行抗病毒治疗的有益效果。
Epstein–Barr virus (EBV)-associated lymphoma may arise secondary to angioimmunoblastic T-cell lymphoma (AITL). The prognosis is poor despite chemotherapy and experimental therapies. We report on a 40-year-old woman with AITL without obvious immunodeficiency in which EBV-associated lymphoma developed. The occurrence and size of enlarged lymph nodes correlated strongly with the EBV load in serum (EBVL). Treatment with valacyclovir at the early stage resulted in a drastic more than 3 log10 decrease of EBVL and complete remission. However, valacyclovir had to be stopped after 6 months due to side effects, and the lymphoma reoccurred 3 months later associated with increasing EBVL. Eventually started cytotoxic chemo- and anti-CD20 therapy resulted only in partial remission. The lymphoma progressed and 33 months after it was diagnosed the patient died. This case report demonstrates the close association of EBVL and AITL and a beneficial effect of antiviral therapy at an initial stage of disease manifestation.