Lymphoma and immunosuppression: a report of a case associated with efalizumab therapy

Lymphomas have been associated with immunodeficiency disorders, including those acquired secondary to the use of immunosuppressants for autoimmune disorders and for the prevention of graft rejection. Biologic agents have also been associated with the development of lymphoproliferative disorders. We report the case of Epstein-Barr Virus- negative diffuse large B-cell lymphoma associated with efalizumab, a monoclonal antibody that inhibits T-cell activity. Discontinuation of efalizumab resulted in a partial remission of lymphoma, although administration of chemotherapy was ultimately required. The use of immunomodulators must be tempered with the knowledge of their effect on the immune system and their association with lymphoproliferative disorders.