Abstract |
A 70-year-old man presented with pancytopenia in August 2000, and the results of a bone marrow examination performed in January 2001 confirmed the diagnosis of refractory anemia. He was treated with cyclosporine (CsA) at 3.3 mg/kg per day, and the pancytopenia improved. The patient complained of epigastralgia 21 months later, and a gastric endoscopic examination showed an ulcer with a cleaved bank. A biopsy revealed diffuse large B-cell lymphoma. In situ hybridization analysis detected no Epstein-Barr virus (EBV) in the lymphoma. CsA treatment was discontinued, and a gastrectomy was performed 31 days later. A detailed histologic examination revealed no infiltration of abnormal B-cells in the resected stomach. Although EBV-positive lymphoma is a known complication of immunosuppressive therapy, no causal association between immunosuppressants and EBV-negative lymphoma has been established. The spontaneous remission observed after the withdrawal of CsA treatment suggests that immunosuppressive therapy can be a pathogenic factor in a subset of EBV-negative lymphomas.
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Authors | Masao Ogata, Hiroshi Kikuchi, Keiji Ono, Eiichi Ohtsuka, Ayako Gamachi, Kenji Kashima, Masaru Nasu |
Journal | International journal of hematology
(Int J Hematol)
Vol. 79
Issue 2
Pg. 161-4
(Feb 2004)
ISSN: 0925-5710 [Print] Japan |
PMID | 15005345
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Immunosuppressive Agents
- Cyclosporine
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Topics |
- Aged
- Anemia, Refractory
(drug therapy)
- Cyclosporine
(adverse effects)
- Epstein-Barr Virus Infections
- Humans
- Immunosuppressive Agents
(adverse effects)
- Lymphoma, Non-Hodgkin
(chemically induced, pathology, virology)
- Male
- Remission, Spontaneous
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