title: Hemophagocytic lymphohistiocytosis as severe adverse event of antineoplastic treatment in children.
abstract: Hemophagocytic lymphohistiocytosis (HLH) during childhood cancer treatment is a rare adverse event posing major diagnostic and therapeutic challenges. Between 1995 and 2006, 6 children developed HLH while on conventional chemotherapy (n=4) or after allogeneic stem cell transplantation (n=2). Treatment of HLH included dexamethasone and etoposide, 2 children additionally received infliximab or daclizumab. Three children survived, whereas 3 children died 2, 5, and 47 days after diagnosis of HLH. HLH is a severe adverse event of childhood cancer therapy. Early diagnosis and immediate initiation of adequate treatment are mandatory to overcome this severe condition.
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria. herwig.lackner@meduni-graz.at
authors.forename: Herwig
authors.initials: H
authors.lastname: Lackner
authors.forename: Christian
authors.initials: C
authors.lastname: Urban
authors.forename: Petra
authors.initials: P
authors.lastname: Sovinz
authors.forename: Martin
authors.initials: M
authors.lastname: Benesch
authors.forename: Andrea
authors.initials: A
authors.lastname: Moser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schwinger
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D000077561:Daclizumab; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000009:adverse effects; D007223:Infant; D000069285:Infliximab; D051359:Lymphohistiocytosis, Hemophagocytic / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D005047:Etoposide; D003907:Dexamethasone; D000069285:Infliximab; D000077561:Daclizumab