immunosuppression

EBV-Positive Lymphoproliferative Diseases: A New Concept and Differential Diagnosis (Literature Review and Case Reports)

LYMPHOID TUMORS , , , , , , , ,

АM Kovrigina

National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Professor Alla Mikhailovna Kovrigina, PhD in Biology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; e-mail: kovrigina.alla@gmail.com

For citation: Kovrigina AM. EBV-Positive Lymphoproliferative Diseases: A New Concept and Differential Diagnosis (Literature Review and Case Reports). Clinical oncohematology. 2018;11(4):326–37.

DOI: 10.21320/2500-2139-2018-11-4-326-337

ABSTRACT

In recent years increasing attention focuses on the concept of EBV-positive lymphoproliferative diseases related to primary or secondary immunodeficiency resulting from immunosuppressive therapy and persistent infections. Due to the progress of treatment methods in oncohematology and oncology this pathology also occurs as a delayed event when new surgical and therapeutic approaches are applied. The paper presents proof for the pathogenetic significance of Epstein-Barr virus (EBV) in the pathology under consideration with its various clinical manifestations and describes the evolution of knowledge on posttransplant lymphoproliferative disorders with their morphological classification underlying EBV+ lymphoproliferative diseases. The WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues revised in 2017 includes new forms of EBV+ lymphoproliferative diseases (mucocutaneous ulcer, T- and NK-cell childhood lymphoproliferative disorders including cutaneous and systemic forms of chronic active EBV infection) and EBV+ large B-cell lymphomas (unspecified and fibrin-associated diffuse large B-cell lymphomas). The paper summarizes major characteristics of these diseases and exemplifies them by the author’s own experience.

Keywords: B-, T-, NK-cell lymphoproliferative diseases, Epstein-Barr virus (EBV), immunodeficiency, immune imbalance, immunosuppression, morphology, diagnosis.

Received: July 20, 2018

Accepted: September 25, 2018

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REFERENCES

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  19. Dojcinov SD, Venkataraman G, Raffeld M, et al. EBV positive mucocutaneous ulcer–a study of 26 cases associated with various sources of immunosuppression. Am J Surg Pathol. 2010;34(3):405–17. doi: 10.1097/PAS.0b013e3181cf8622.

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Chronic hepatitis B and hematological malignancies

VIRAL INFECTIONS IN ONCOHEMATOLOGY , , ,

A.O. Buyeverov1, P.O. Bogomolov2

1 I.M. Sechenov First Moscow State University, RF Ministry of Health, Moscow, Russian Federation

2 M.F. Vladimirsky Moscow Regional Research-and-Clinical Institute, Moscow, Russian Federation

ABSTRACT

The active usage of monoclonal antibodies in therapy for hematology malignancies made reactivation of hepatitis B virus (HBV) infection one of the major health problems. Monoclonal antibodies are also used in solid tumors, rheumatic, gastroenterological, and skin diseases. Identification of patients with active, inactive, or latent HBV infection with the high risk of reactivation and appropriate antiviral therapy decreases the risk of liver damage and allows the complete course of cancer treatment. Preventive anti-HBV therapy is based on nucleoside analogues that should be chosen in accordance to their efficacy and considering the risk of resistant viral strain selection during long-term treatment. Existing preventive regimens require improvement that warrants further prospective trials for elaboration of optimal recommendations. Thus, prevention of HBV infection reactivation in patients receiving immunosuppressive drugs should include nucleoside analogues according to the HBV infection phase, as well as the therapeutic regimen and duration of treatment.

Keywords: chronic hepatitis B, immunosuppression, nucleoside analogues, entecavir.

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