World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
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Letter to the Editor

Volume 11, Number 1, February 2020, pages 41-43

The Emergence of Epstein-Barr Virus-Related Diffuse Large B-Cell Lymphoma With Mogamulizumab


Figure 1.
Figure 1. PET-CT panel with initial PET-CT, PET-CT with progression in February, 2019, PET-CT in May, 2019 and PET in July, 2019. (a) PET-CT at initial diagnosis. (b) PET-CT after brentuximab. (c) PET-CT with progression on brentuximab. (d) PET-CT with progression on mogamulizumab. PET-CT: positron emission tomography-computed tomography.
Figure 2.
Figure 2. Pathology images/panel with EBV+ DLBCL. (a) H&E stain showing large lymphoma cells infiltrating the tissue in sheets (× 10). (b) CD20 IHC (× 10). (c) BCL2 IHC (× 10). (d) BCL6 IHC (× 10). (e) CD21 IHC (× 10). (f) CD23 IHC (× 10). (g) CD30 IHC (× 10). (h) OCT2 IHC (× 10). (i) MUM1 IHC (× 10). (j) Twenty to thirty percent of cells positive for MYC IHC (× 10). (k) High proliferation index (80-90%) by Ki-67 IHC (× 10). (l) Patchy positive EBER-ISH (× 10). EBV: Epstein-Barr virus; DLBCL: diffuse large B-cell lymphoma; H&E: hematoxylin and eosin stain; IHC: immunohistochemistry; ISH: in situ hybridization; CD: cluster of differentiation.


Table 1. Summary of All Reported Patients Treated with Mogamulizumab and Developed EBV-Associated DLBCL
ReferenceNumber of patients in studyAge (years)Line and type of therapyPost mogamulizumab secondary malignancyDuration of treatment of mogamulizumab before diagnosis of DLBCL
EBV: Epstein-Barr virus; DLBCL: diffuse large B-cell lymphoma; CNS: central nervous system; CD: cluster of differentiation.
Kamachi et al, 2019 [8]183One line. THP-COP (pirarubicin, cyclophosphamide, vincristine, and prednisolone) then THP-COP combined with mogamulizumab.EBV-related CNS DLBCLFive cycles
Tanaka et al, 2017 [10]166Two lines. The first line: CHOP (doxorubicin, vincristine, cyclophosphamide and prednisone). The second line CHASE (etoposide, cyclophosphamide, cytarabine, dexamethasone). Then mogamulizumab as single agent.EBV-related CNS DLBCLSeven cycles
Wang et al, 2020173One line. Brentuximab vedotin (CD30 monoclonal antibodies)Systemic DLBCL with no CNS involvedTen cycles