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Correspondence
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Volume 341:55 July 1, 1999 Number 1
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Epstein–Barr Virus–Associated Lymphoma after Treatment of Macroglobulinemia with Cladribine

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To the Editor: Purine analogues, including cladribine (2-chlorodeoxyadenosine), are increasingly used in the treatment of Waldenström's macroglobulinemia and other hematologic cancers.1 Cladribine can cause profound immunosuppression, lymphopenia, and increased susceptibility to opportunistic infections.2 We report on a patient with Waldenström's macroglobulinemia in whom an Epstein–Barr virus (EBV)–associated diffuse large-cell lymphoma developed after treatment with cladribine.

A 69-year-old woman received the diagnosis of Waldenström's macroglobulinemia with IgM kappa in 1991. Because of the progression of the disease, treatment with standard doses of cladribine was initiated in June 1994 and repeated in August 1994. The patient had a remarkable response, with alleviation . . . [Full Text of this Article]

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