Severe T-mediated bone marrow aplasia in a patient with splenic lymphoma with villous lymphocytes (SLVL) previously treated with fludarabine regimen.

Splenic Lymphoma with villous lymphocytes (SLVL) is a B cell chronic lymphoproliferative disorder defined in the WHO classification as the leukemic form of splenic marginal zone lymphoma. Autoimmune diseases or second neoplasms in patients affected by B cell chronic lymphoproliferative disorders are well known conditions after fludarabine containing regimens (above all in the case of Chronic Lymphocytic Leukemia). However, T lymphoproliferative disorders able to induce a severe bone marrow aplasia were never described in patients affected by SLVL and treated with Fludarabine. We report a case of SLVL in which a severe T-mediated bone marrow aplasia occurred six months after Fludarabine treatment.