[Early relapse of hemophagocytic syndrome after reduced-intensity cord blood transplantation for relapsed acute lymphoblastic leukemia].
We report a 4-year-old girl who presented with acute onset of hemophagocytic syndrome (HPS) after induction therapy and HPS relapsed immediately after reduced-intensity cord blood transplantation (RI-CBT) for relapse of acute lymphoblastic leukemia. The patient underwent CBT from 2 locus-mismatched donor, after reduced-intensity conditioning therapy consisting of fludarabine, melphalan, and total body irradiation 4Gy. Prednisolone and cyclosporine were administered for prophylaxis against graft-versus-host disease. Bone marrow examination on day 20 revealed activated macrophages displaying hemophagocytosis. The origin of macrophages was 2(nd) donor derived. After administration of steroids, intravenous immunoglobulin and VP-16, the patient exhibited complete chimerism and remained in complete remission for over one year.
Nodomi
Seishiro
S
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kato
Itaru
I
Daifu
Tomoo
T
Saida
Satoshi
S
Morishima
Tatsuya
T
Matsubara
Hiroshi
H
Umeda
Katsuji
K
Watanabe
Ken-ichiro
K
Maruya
Etsuko
E
Saji
Hiroo
H
Nakahata
Tatsutoshi
T
Adachi
Souichi
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology* / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D014916:Whole-Body Irradiation