Development and rapid dissemination of Merkel-cell carcinomatosis following therapy with fludarabine and rituximab for relapsing follicular lymphoma

Eur J Haematol. 2002 Feb;68(2):117-9. doi: 10.1034/j.1600-0609.2002.01600.x.


This report deals with an unusual case of a patient with follicular small cleaved lymphocytic lymphoma who developed Merkel-cell carcinoma soon after receiving chemoimmunotherapy with a fludarabine-containing regimen and rituximab. The presentation of the Merkel-cell carcinoma in this patient was atypical because of the absence of dermal involvement and the very rapid clinical progression. In the light of recent reports which suggest a possible link between the immunocompromised state and the development of Merkel-cell carcinoma, the atypical presentation seen in this patient may indeed imply a possible link between the therapy given and the development of Merkel-cell carcinoma. To the best of our knowledge, this is the first documentation of Merkel-cell carcinoma appearing in a patient soon after treatment with fludarabine and/or rituximab.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Carcinoma, Merkel Cell / etiology*
  • Carcinoma, Merkel Cell / pathology
  • Humans
  • Lymphoma, Follicular / drug therapy*
  • Lymphoma, Follicular / pathology
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / etiology
  • Neoplasms, Second Primary / pathology
  • Recurrence
  • Rituximab
  • Salvage Therapy
  • Vidarabine / administration & dosage
  • Vidarabine / adverse effects*
  • Vidarabine / analogs & derivatives


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Rituximab
  • Vidarabine
  • fludarabine