Systemic Epstein-Barr virus-positive T-cell lymphoma in an adult patient with chronic myeloid leukemia receiving a tyrosine kinase inhibitor

Abstract

 Systemic Epstein-Barr virus (EBV)-positive T-cell lymphoma (TCL) of childhood rarely develops in adults. The first case of systemic EBV-positive TCL, which occurred in an adult patient with chronic myeloid leukemia who was treated with a tyrosine kinase inhibitor (TKI), is reported. The patient was treated with nilotinib (TKI) for two years. He presented with a two-month history of cervical lymphadenopathy, common cold symptoms and had high titers of EBV in peripheral blood. A lymph node biopsy showed CD8-positive atypical T cells with EBV infection. Because of the pathological finding of EBV-positive T-cell lymphoma and status of EBV reactivation, we diagnosed him with systemic EBV-positive TCL. Conventional chemotherapy followed by hematopoietic stem cell transplantation was a valuable therapeutic option for this patient. TKIs are likely to inhibit T-cell activation and proliferation, and might be involved in the onset of systemic EBV-positive TCL.