AITL with EBV+ B-cell expansion (large B-cells, EBER+ in microenvironment) — risk of seco...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | RF-AITL-EBV-DRIVEN-B-CELL |
|---|---|
| Type | Red flag |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | DIS-AITL |
| Sources | SRC-ESMO-PTCL-2024 SRC-NCCN-BCELL-2025 |
Red Flag Origin
| Definition | AITL with EBV+ B-cell expansion (large B-cells, EBER+ in microenvironment) — risk of secondary EBV-driven B-cell lymphoma (DLBCL-like) emerging during/after T-cell-directed therapy |
|---|---|
| Clinical direction | investigate |
| Category | high-risk-biology |
Trigger Logic
{
"any_of": [
{
"finding": "BIO-EBV-STATUS",
"value": "positive"
},
{
"finding": "ebv_positive_b_cells",
"value": true
},
{
"finding": "ebv_dna_serum_positive",
"value": true
}
],
"type": "composite_clinical"
}
Notes
AITL microenvironment classically contains EBV+ B-cells (~80-90%). Subset develops EBV-driven secondary B-cell lymphoma (often DLBCL-like) during/after T-cell-directed induction — clonally distinct from index AITL. Rebiopsy any new dominant mass; if CD20+/EBER+ DLBCL → add rituximab + treat as B-cell. Serum EBV-DNA rising trend = early warning. Not an algorithm switch (still treat AITL backbone) but mandatory surveillance flag.
Used By
Algorithms
ALGO-AITL-1L- ALGO-AITL-1L
Indications
IND-AITL-2L-AZACITIDINE- IND-AITL-2L-AZACITIDINEIND-AITL-2L-BELINOSTAT- IND-AITL-2L-BELINOSTATIND-AITL-2L-ROMIDEPSIN- IND-AITL-2L-ROMIDEPSIN