Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

Detection of Epstein-Barr virus in transformations of low-grade B-cell lymphomas after fludarabine treatment.

Publication ,  Journal Article
Shields, DJ; Byrd, JC; Abbondanzo, SL; Lichy, JH; Diehl, LF; Aguilera, NI
Published in: Mod Pathol
November 1997

Fludarabine is a highly effective chemotherapeutic agent for chronic lymphocytic leukemia/small lymphocytic lymphoma and is also active in other B-cell lymphoproliferative disorders. Although highly efficacious in destroying the malignant B-cells, fludarabine also causes T-cell lymphopenia and immunosuppression. We present five patients given fludarabine for low-grade B-cell lymphoproliferative disorders who showed transformation of the primary neoplasm to a higher grade tumor. Immunohistologic antibody studies were performed on paraffin-embedded tissue sections of the initial tissue (when available) and on the follow-up biopsy specimens for CD20, CD3, CD45RO, CD43, CD30, CD15, and latent membrane protein (LMP-1) for Epstein-Barr virus (EBV). The initial diagnoses in these five patients included chronic lymphocytic leukemia/small lymphocytic lymphoma (three cases), follicle center lymphoma (one case), and Waldenstrom's macroglobulinemia (one case). All of the follow-up biopsy specimens showed scattered Hodgkin's-like cells, and two of the five also showed foci of large-cell transformation. The Hodgkin's-like cells showed CD30 immunoreactivity in four of the five cases and CD15 immunoreactivity in three of the five. Strong immunoreactivity of the large, atypical, Hodgkin's-like cells for LMP-1 of EBV was noted in four cases; in the remaining case, this finding was equivocal. In situ hybridization for EBV-encoded RNA was positive in four of the five cases. Molecular studies by polymerase chain reaction (PCR) showed the presence of EBV in three of the five cases. PCR for detection of immunoglobulin heavy chain demonstrated identical monoclonal rearrangements in the original lymphoma and transformation in one case with available material. The CD4 lymphocyte count in each patient was less than 550/microL, indicating cellular dysfunction. Transformation of low-grade non-Hodgkin's lymphomas after fludarabine therapy might be associated with EBV and severe immunosuppression.

Duke Scholars

Published In

Mod Pathol

ISSN

0893-3952

Publication Date

November 1997

Volume

10

Issue

11

Start / End Page

1151 / 1159

Location

United States

Related Subject Headings

  • Viral Matrix Proteins
  • Vidarabine
  • RNA, Viral
  • Polymerase Chain Reaction
  • Pathology
  • Middle Aged
  • Male
  • Lymphoma, Non-Hodgkin
  • Lymphoma, B-Cell
  • In Situ Hybridization
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Shields, D. J., Byrd, J. C., Abbondanzo, S. L., Lichy, J. H., Diehl, L. F., & Aguilera, N. I. (1997). Detection of Epstein-Barr virus in transformations of low-grade B-cell lymphomas after fludarabine treatment. Mod Pathol, 10(11), 1151–1159.
Shields, D. J., J. C. Byrd, S. L. Abbondanzo, J. H. Lichy, L. F. Diehl, and N. I. Aguilera. “Detection of Epstein-Barr virus in transformations of low-grade B-cell lymphomas after fludarabine treatment.Mod Pathol 10, no. 11 (November 1997): 1151–59.
Shields DJ, Byrd JC, Abbondanzo SL, Lichy JH, Diehl LF, Aguilera NI. Detection of Epstein-Barr virus in transformations of low-grade B-cell lymphomas after fludarabine treatment. Mod Pathol. 1997 Nov;10(11):1151–9.
Shields, D. J., et al. “Detection of Epstein-Barr virus in transformations of low-grade B-cell lymphomas after fludarabine treatment.Mod Pathol, vol. 10, no. 11, Nov. 1997, pp. 1151–59.
Shields DJ, Byrd JC, Abbondanzo SL, Lichy JH, Diehl LF, Aguilera NI. Detection of Epstein-Barr virus in transformations of low-grade B-cell lymphomas after fludarabine treatment. Mod Pathol. 1997 Nov;10(11):1151–1159.

Published In

Mod Pathol

ISSN

0893-3952

Publication Date

November 1997

Volume

10

Issue

11

Start / End Page

1151 / 1159

Location

United States

Related Subject Headings

  • Viral Matrix Proteins
  • Vidarabine
  • RNA, Viral
  • Polymerase Chain Reaction
  • Pathology
  • Middle Aged
  • Male
  • Lymphoma, Non-Hodgkin
  • Lymphoma, B-Cell
  • In Situ Hybridization