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 Blood, 15 August 2008, Vol. 112, No. 4, pp. 1039-1041.
Prepublished online as a Blood First Edition Paper on May 23, 2008; DOI 10.1182/blood-2008-02-138800.

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CLINICAL TRIALS AND OBSERVATIONS

Brief Report

EBV-positive immunodeficiency lymphoma after alemtuzumab-CHOP therapy for peripheral T-cell lymphoma

Hanneke C. Kluin-Nelemans1, Jules L. Coenen2, James E. Boers3, Gustaaf W. van Imhoff1, and Stefano Rosati4

1 Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen; Departments of2 Internal Medicine and 3 Pathology, Isala Klinieken, Zwolle; and 4 Departments of Pathology and Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Chemotherapy with alemtuzumab and the combination of cyclophosphamide, adriamycin, oncovin, and prednisone (CHOP) has become experimental trial therapy for aggressive T-cell lymphoma. Several multicenter phase 3 trials will incorporate this scheme. As part of an ongoing phase 2 trial in which we recently treated 20 patients with 8 cycles of CHOP every 2 weeks with 3 additional doses of 30 mg alemtuzumab per cycle, we observed the development of Epstein-Barr virus (EBV)-positive lymphoproliferative disease, after completion of the immunochemotherapy in 3 patients with peripheral T-cell lymphoma. Because the occurrence of EBV-positive lymphoproliferative disease is rare after alemtuzumab monotherapy, such as is given for chronic lymphocytic leukemia, we think that early reporting of this potential side effect is warranted. It may be caused by intrinsic T-cell defects in patients with T-cell lymphoma, or by the combination of alemtuzumab with CHOP chemotherapy.


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