Hemophagocytic lymphohistiocytosis onset during induction therapy for precursor B-cell acute lymphoblastic leukemia.
We report the clinical course of a child with precursor B-cell acute lymphoblastic leukemia who developed fever, hepatosplenomegaly, and refractory thrombocytopenia after initiation of chemotherapy. Bone marrow aspiration on Day 8 of induction showed new onset of hemophagocytosis and he met clinical, laboratory, and histopathologic criteria for hemophagocytic lymphohistiocytosis. His symptoms improved significantly after an increased dosage of steroids.
Breakey
Vicky R
VR
Division of Pediatric Haematology and Oncology, Department of Paediatric Medicine, Hospital for Sick Children, Toronto, Canada. vsventzouris@yahoo.com
Abdelhaleem
Mohammed
M
Weitzman
Sheila
S
Abla
Oussama
O
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001215:Asparaginase / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage; D005334:Fever / Q000209:etiology; D006529:Hepatomegaly / Q000139:chemically induced; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012074:Remission Induction; D013163:Splenomegaly / Q000139:chemically induced; D013921:Thrombocytopenia / Q000139:chemically induced; D014750:Vincristine / Q000008:administration & dosage
D011092:Polyethylene Glycols; D014750:Vincristine; C042705:pegaspargase; D003907:Dexamethasone; D001215:Asparaginase