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• W2034585655 abstract "Epstein–Barr virus (EBV)-positive diffuse largeB-cell lymphoma (DLBCL) of the elderly is a novelentity included in the World Health Organization(WHO) classification of hematopoietic and lymphoidtumors [1]. EBV-positive DLBCL of the elderly is avery aggressive disease that occurs more frequently inpatients older than 50 years and presents withfrequent extranodal involvement and the presenceof EBV in tumoral cells. The prognosis is poor andthe survival is short [2]. A few studies have reportedlower response rates to conventional anthracycline-based chemotherapy in comparison with responsesseen in EBV-negative patients with DLBCL [2,3],but there are no data on EBV-positive DLBCL of theelderly treated with rituximab in combination withchemotherapy. In this letter, we present two cases ofEBV-positive DLBCL of the elderly with a goodinitial response to the combination of rituximab,cyclophosphamide, doxorubicin, vincristine, andprednisone (R-CHOP).Our first case is a 74-year-old man without asignificant past medical history and an EasternCooperative Oncology Group (ECOG) performancestatus of 1. One week prior to admission, hedeveloped progressive colicky abdominal pain andbloating. He denied B symptoms. An intestinalobstruction was suspected and a 464 cm ilealmass was identified. The patient underwent a partialileal resection. Pathological studies revealed alymphoproliferative process with monomorphic ap-pearance and scattered areas of necrosis. Based onimmunohistochemical studies, the sample was mostconsistent with a CD20-positive diffuse large B-celllymphoma with a non-germinal center (NGC)phenotype (CD10 negative, BCL6 negative, andMUM1 positive). Expression of CD30 and BCL2was negative, and Ki67 expression was 80%. EBV-encoded RNA (EBER) in situ hybridization (ISH)was positive in the tumoral cells (Figure 1). Furtherstaging showed a 2 cm mass in the lower lobe of theright lung. A bone marrow biopsy was negative forlymphomatous involvement, and lactate dehydro-genase (LDH) levels were within normal limits. Thepatient was diagnosed with stage IVA EBV-positiveDLBCL of the elderly. His International PrognosticIndex (IPI) score was 3. The patient received sixcycles of R-CHOP administered every 21 days withgrowth factor support. At the end of treatment, therewas no evidence of disease. Unfortunately, 12months after his initial diagnosis, the patient pre-sented with seizures, and a computed tomography(CT) scan of the brain showed multiple parenchymallesions consistent with relapsed lymphoma. Thepatient underwent brain irradiation with radiological" @default.
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• W2034585655 date "2011-01-01" @default.
• W2034585655 modified "2023-09-26" @default.
• W2034585655 title "Epstein–Barr virus-positive diffuse large B-cell lymphoma of the elderly treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone: report of two cases from South America" @default.
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• W2034585655 doi "https://doi.org/10.3109/10428194.2010.528094" @default.
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