[Hemophagocytic syndrome associated with neutropenia after chemotherapy].
METHODS
This retrospective study reports 15 cases of hemophagocytic syndrome in children treated in our department during a eight-year period.


RESULTS
Underlying diseases were acute lymphoblastic leukemia (n = 8) acute myeloblastic leukemia (n = 6) and Burkitt lymphoma (n = 1). Hemophagocytic syndrome was suspected after chemotherapy, in case of an unusual prolonged febrile neutropenia (n = 14) or isolated thrombocytopenia (n = 1). That fever was associated with cutaneous, pulmonary, hematologic, digestive and cardiac signs. Biological disorders included hypoprotidemia, hyponatremia, increased liver enzymes and fibrinopenia. Thrombocytopenia was observed in all patients and was associated with neutropenia for 14 of them. Diagnosis of hemophagocytic syndrome was always confirmed by bone marrow aspiration (infiltration with activated macrophages). Infection was documented in eight children. The treatment of hemophagocytic syndrome relied on steroids and resolution of symptoms occurred within three days of therapy. No recurrence of hemophagocytic syndrome was observed with a median follow up of two years and a half.


CONCLUSIONS
Such complication should be suspected in cases of prolonged febrile neutropenia and/or thrombocytopenia, and confirmed by bone marrow aspiration. Indeed, steroid therapy is effective and chemotherapy can be then pursued.
Bertozzi
A I
AI
Unité d'hémato-oncologie pédiatrique hôpital des Enfants, 330, avenue de Grande-Bretagne, BP 31198, 31026 Toulouse, France. bertozzia.i.@chu-toulouse.fr
Suc
A
A
Rubie
H
H
Duchayne
E
E
Demur
C
C
Robert
A
A
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000367:Age Factors; D002051:Burkitt Lymphoma / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D015616:Histiocytosis, Non-Langerhans-Cell / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008297:Male; D009503:Neutropenia / Q000150:complications*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000150:complications*; D013997:Time Factors
D000305:Adrenal Cortex Hormones
Syndromes hémophagocytaires en phase d'aplasie post chimiothérapie.