alexa An Aggressive Transformation to EBV-Positive Hodgkin Lymphoma after Bendamustine-Containing Chemotherapy for Marginal Zone Lymphoma
ISSN: 2329-8790

Journal of Hematology & Thromboembolic Diseases
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Case Report

An Aggressive Transformation to EBV-Positive Hodgkin Lymphoma after Bendamustine-Containing Chemotherapy for Marginal Zone Lymphoma

Hideyuki Nakazawa1*, Hitoshi Sakai1, Toru Kawakami1, Yukio Hirabayashi2, Ko Nakazawa3, Naoko Asano4, Fumihiro Ishida1,5 and Kiyoshi Kitano2

1Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan

2Department of Hematology, NHO Matsumoto Medical Center, Matsumoto, Japan

3Department of Laboratory Medicine, NHO Matsumoto Medical Center, Matsumoto, Japan

4Department of Molecular Diagnosis, Nagano Prefectural Suzaka Hospital, Suzaka, Japan

5Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, Matsumoto, Japan

*Corresponding Author:
Hideyuki Nakazawa
Division of Hematology, Department of Internal Medicine
Shinshu University School of Medicine, Matsumoto, Japan
3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
E-mail: [email protected]

Received date: May 26, 2016; Accepted date: June 14, 2016; Published date: June 21, 2016

Citation: Nakazawa H, Sakai H, Kawakami T, Hirabayashi Y, Nakazawa K, et al. (2016) An Aggressive Transformation to EBV-Positive Hodgkin Lymphoma after Bendamustine-Containing Chemotherapy for Marginal Zone Lymphoma. J Hematol Thrombo Dis 4:246. doi:10.4172/2329-8790.1000246

Copyright: © 2016, Nakazawa H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



EBV-positivelymphoproliferative disorders are well documented phenomenon after fludarabine therapy. Although bendamustine shares common chemical structure with fludarabine, therapy-related malignancies have rarely been reported. A seventy-three-year-old man was presented with splenomegaly and pharyngeal mass. The biopsies of bone marrow and the mucosal mass revealed he had splenic marginal zone lymphoma, stage IV. Six months later, he received one course of R-CHOP and splenectomy. Three months after the surgery, the lymphoma progressed with massive pleural effusion, and six courses of bendamustine plus rituximab, yielding minimal response of the disease. Six months after the completion of bendamustine, however, Pel-Ebstein-like fever and progression of lymphadenopathy ensued. A lymph node biopsy exhibited he had EBV-positive classical Hodgkin lymphoma concomitant with marginal zone lymphoma. The patient achieved complete response after brentuximab vedotin therapy. The Hodgkin lymphoma in the present case might be a result of an aggressive transformation of marginal zone lymphoma, and it could be speculated that the purine analogue-like property of bendamustine be associated with the transformation.


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