Successful Treatment of a Patient With Epstein-Barr Virus–Positive B-Cell Lymphoproliferative Disorder Resembling Post-Transplant Lymphoproliferative Disorder Using Single-Agent Rituximab

Lymphoproliferative disorders that are associated with the Epstein-Barr virus (EBV) are most common after organ and allogeneic bone marrow or stem-cell transplantation. These disorders are rare but can be quite serious. Multiple treatment regimens have been attempted, including the anti-CD20 monoclonal antibody rituximab.1 Nontransplantation-related EBV-positive lymphoproliferative disorders such as age-related EBV-positive diffuse large-cell lymphoma also occur, although less commonly. There is no standard management for these latter disorders.2 We herein describe an elderly patient with no prior history of transplantation or known immunodeficiency who developed a life-threatening lymphoproliferative disorder that was associated with a clonal immunoglobulin gene rearrangement secondary to EBV. The patient was treated successfully with single-agent rituximab.