OncoTargets and Therapy (Apr 2021)

Promising Response to Lenalidomide-Combination Therapy in a Discordant Lymphoma Consisting of EBV-Positive Diffuse Large B-Cell Lymphoma and Angioimmunoblastic T-Cell Lymphoma: A Case Report

  • Hu P,
  • Ben Y,
  • Liu J,
  • Zheng W,
  • Yan X,
  • Zhang Y,
  • Shi W

Journal volume & issue
Vol. Volume 14
pp. 2489 – 2495

Abstract

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Pan Hu,1,* Yu Ben,1,* Juan Liu,1 Weicheng Zheng,1 Xiyue Yan,1 Yaping Zhang,2 Wenyu Shi1,2 1Department of Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China; 2Department of Hematology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenyu ShiDepartment of Oncology and Hematology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of ChinaTel +86-513-81160502Fax +86-513-85519820Email [email protected] ZhangDepartment of Hematology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of ChinaTel +86-513-81160502Fax +86-513-85519820Email [email protected]: Epstein–Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) complicated with angioimmunoblastic T-cell lymphoma (AITL) is extremely rare and typically shows an aggressive clinical course and unsatisfactory prognosis. Here, we describe the case of a 77-year-old man who was referred to the hospital because of repeated fever, night sweats, and weight loss. He was finally diagnosed with a discordant lymphoma consisting of AITL and DLBCL, with significantly different maximum standardized uptake values on positron emission tomography/computed tomography. Based on his complex illness and poor performance status, the patient received six cycles of lenalidomide combined with R-miniCHOP regimen and achieved complete remission with tolerable and controlled toxicity. He subsequently received lenalidomide maintenance therapy and achieved sustained remission. We consider the possible causes of this discordance involved AITL and EBV-positive DLBCL, and the possible mechanism of lenalidomide action in both T-cell and B-cell non-Hodgkin lymphomas. Lenalidomide-combination therapy may be a preferable choice in patients with an EBV-associated discordant lymphoma.Keywords: Epstein–Barr virus, diffuse large B-cell lymphoma, angioimmunoblastic T-cell lymphoma, discordant lymphoma, lenalidomide, positron emission tomography/computed tomography

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