Spontaneous regression of dasatinib-related primary effusion lymphoma-like lymphoma

Abstract

Primary effusion lymphoma-like lymphoma (PEL-LL) shows a unique clinical presentation, characterized by lymphomatous effusions in the body cavities. PEL-LL may be associated with hepatitis C virus infections and fluid overload states; and owing to its rarity, no standard therapies have been established. We report a case of a 55-year-old woman who developed PEL-LL during treatment with dasatinib, for chronic myeloid leukemia (CML). She presented to our hospital with dyspnea lasting for approximately a month and showed pericardial and bilateral pleural effusions. The pericardial effusion was exudative, and cytopathological and immunophenotypic examinations showed numerous CD 20-positive, large atypical lymphoid cells, which were also positive for the Epstein-Barr virus gene. No evidence of lymphadenopathy or bone marrow infiltration was found. We diagnosed PEL-LL, immediately discontinued dasatinib, and performed continuous drainage of the pericardial effusions. Complete response was achieved, and remission was maintained for 15 months. Two months after discontinuation of dasatinib, she was administered imatinib and a deep molecular response for the CML was maintained. PEL-LL occurring during dasatinib treatment is rare. We compared the results of previous reports with this case, and found that early diagnosis of PEL-LL, discontinuation of dasatinib, and sufficient drainage can improve the prognosis of PEL-LL.

Cavity-based lymphomas: challenges and novel concepts. A report of the 2022 EA4HP/SH lymphoma workshop

“…6 ) and immunotherapy (LYWS-1088 M. Chiselite). Dasatinib has been associated with pleural effusions [ 33 ], with a handful of case reports describing lymphomatous effusions, all with CD20 expression but the variable expression of EBV [ 34 – 37 ]. The other EBV-positive cases reported in the literature with detailed clinical history occurred mostly in elderly immunodeficient (e.g., HIV, post-transplant, common variable immunodeficiency, idiopathic CD4+ T lymphocytopenia) or immunosuppressed patients (e.g., prednisone, cyclosporine) [ 29 , 32 ].…”

Development of a human herpesvirus 8-negative effusion-based lymphoma during treatment with dasatinib for chronic myeloid leukemia

“… 9 The last of the three patients treated with drainage, maintained remission for 18 months. 10 The state of molecular response (MR) after stopping dasatinib was not described in relation to one of the three patients. The other two patients maintained deep molecular response (DMR) with imatinib ( Table 1 ).…”

“…6 To date, six cases of HHV8-negative EBL developed during dasatinib treatment, have been reported. [7][8][9][10][11] Here, we report a rare case of HHV8-negative EBL that developed during long-lasting dasatinib-induced PE.…”