Abstract
The development of B-cell lymphomas has been seldom described in HTLV-1 carriers. We present the case of an elderly Peruvian HTLV-1 carrier who was diagnosed with EBV-positive diffuse large B-cell lymphoma. Despite an initial good response to therapy, patient died during treatment due to fatal Pneumocystis jirovecci pneumonia. EBV infection is characterized by B-cell lymphotropism and selective immunodeficiency. HTLV-1, on the other hand, induces T-cell dysfunction and B-cell proliferation. Finally, immunosenescence is characterized by T-cell dysregulation, decreased apoptosis and cytokine upregulation. In this elderly patient, the combination of EBV and HTLV-1 coinfection and immunosenescence may have played a role in the development of this aggressive diffuse large B-cell lymphoma. Furthermore, the immunodeficiency caused by the viral infections and chemotherapy may have played a role in developing life-threatening infectious complications.
Highlights
Epstein Barr virus (EBV) expression has been reported in patients with diffuse large B-cell lymphoma (DLBCL) [6]
The Epstein Barr virus (EBV) was the first described oncovirus, which has been associated with the development of a variety of lymphoproliferative disorders, such as Burkitt [1], primary CNS [2], NK/T-cell [3], plasmablastic [4] and Hodgkin lymphoma [5]
human T-lymphotropic virus type 1 (HTLV-1) is endemic in Japan, the Melanesian Islands, the Caribbean, South America, the Middle East and parts of Africa
Summary
EBV expression has been reported in patients with diffuse large B-cell lymphoma (DLBCL) [6]. The human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus and is the pathogenic agent of adult T-cell lymphoma/leukemia (ATLL) and other diseases [9]. EBV nuclear antigens (EBNA-LP, -1, -2 and -3) are the first to be produced after infection; these products are essential for immortalization of the cell and upregulation of the expression of other molecules and genes such as the latent membrane proteins (LMP-1 and -2).
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