A case of AITL complicated by EBV-positive B cell and monoclonal plasma cell proliferation and effectively treated with lenalidomide.

Abstract

Angioimmunoblastic T-cell lymphoma (AITL) is a common subtype of peripheral T-cell lymphoma with an aggressive clinical course and poor prognosis after conventional chemotherapy, for which there is no current standard of care. We describe here an 87-year-old woman with AITL, whose clinical diagnosis was complicated by the presence of B immunoblasts positive for Epstein-Barr virus in the lymph nodes and monoclonal plasma cells in the bone marrow at initial presentation. Rebiopsy of the lymph node led to the correct diagnosis of AITL with concurrent smoldering plasma cell myeloma. She was treated with several courses of conventional chemotherapy, resulting in progressive disease, and then switched to the immunomodulatory drug lenalidomide, which used in Japan for the treatment of multiple myeloma. Lenalidomide was effective in controlling both AITL and plasma cell myeloma.

• Authors: Wataru Kishimoto, Yoko Takiuchi, Yoshiki Nakae, Sumie Tabata, Akiko Fukunaga, Naomi Matsuzaki, Yoshiaki Yuba, Toshiyuki Kitano, Nobuyoshi Arima
• Journal: International journal of hematology (Int J Hematol) Vol. 109 Issue 4 Pg. 499-504 (Apr 2019) ISSN: 1865-3774 [Electronic] Japan
• PMID: 30604313 (Publication Type: Case Reports, Journal Article)

Chemical References

• Lenalidomide

Topics

• Aged, 80 and over
• Cell Proliferation
• Epstein-Barr Virus Infections (blood, diagnosis, drug therapy, virology)
• Female
• Herpesvirus 4, Human
• Humans
• Lenalidomide (administration & dosage)
• Lymphoma, T-Cell, Peripheral (blood, diagnosis, drug therapy, virology)
• Plasma Cells (metabolism)