Epstein–Barr Virus–Associated Lymphoma after Treatment of Macroglobulinemia with Cladribine

Abstract
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.