与利妥昔单抗使用相关的爱泼斯坦-巴尔病毒噬血细胞性淋巴组织细胞增生症及免疫发病机制见解
Epstein barr virus hemophagocytic lymphohistiocytosis related to rituximab use and immunopathogenetic insights.
作者信息
Papageorgiou Sotirios G, Tsiodras Sotirios, Siakallis Georgios, Bazani Efthimia, Spathis Aris, Poulakou Garyfalia, Korkolopoulou Penelope, Panayiotides Ioannis, Pappa Vasiliki
机构信息
2nd Department of Internal Medicine, Propaedeutic, Hematology Unit, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Haidari, Greece.
4th Department of Internal Medicine, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
出版信息
Pathol Res Pract. 2016 Dec;212(12):1194-1198. doi: 10.1016/j.prp.2016.10.003. Epub 2016 Oct 17.
Anti-CD20-based chemo-immunotherapeutic regimens have been suggested to assist in the management of Epstein-Barr virus (EBV)-induced hemophagocytic lymphohistiocytosis (HLH) and EBV-associated post-transplant lymphoproliferative disorders (EBV-PTLD), by reducing EBV viral load and EBV-induced inflammation. Herein we report a fatal EBV-related HLH in the context of Hodgkin lymphoma (HL)-like Richter's transformation of B chronic lymphocytic leukemia (B-CLL), two months after rituximab treatment. The complex balance between EBV driven T-cell stimulation and immunosuppressive therapy in the context of multiple immune deficits is discussed.
基于抗CD20的化学免疫治疗方案已被建议用于辅助治疗爱泼斯坦-巴尔病毒（EBV）诱导的噬血细胞性淋巴组织细胞增生症（HLH）和EBV相关的移植后淋巴增殖性疾病（EBV-PTLD），通过降低EBV病毒载量和EBV诱导的炎症反应。在此，我们报告1例在利妥昔单抗治疗2个月后，发生于B细胞慢性淋巴细胞白血病（B-CLL）向霍奇金淋巴瘤（HL）样Richter转化背景下的致命性EBV相关HLH。本文还讨论了在多种免疫缺陷情况下，EBV驱动的T细胞刺激与免疫抑制治疗之间的复杂平衡。
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