Early-onset hemophagocytic lymphohistiocytosis after the start of chemotherapy for advanced neuroblastoma.
The authors report the clinical course of a 3-year-old boy with stage 4 neuroblastoma (NB) complicated by hemophagocytic lymphohistiocytosis (HLH) immediately after the start of chemotherapy. The NB responded very well to the chemotherapy, but the patient developed high fever on the 2nd day, and was diagnosed as having HLH of the 7th day of chemotherapy. No infections were demonstrated, and massive tumor cell destruction resulting from the rapid effect of chemotherapy was thought to be a cause of systemic cytokine response, resulting in HLH. Methylprednisolone pulse therapy was effective for the HLH, which did not recur thereafter. HLH should be recognized as a serious adverse event during chemotherapy for advanced NB that has a large malignant cell load.
Department of Pediatrics, Wakayama Medical University, Kimiidera Wakayama City, Japan. nami@wakayama-med.ac.jp
Shinji
S
Kounami
Keiko
K
Nakayama
Megumi
M
Yoshiyama
Mitsuhiko
M
Rikoh
Takashi
T
Watanabe
Katsuya
K
Takifuji
Norishige
N
Yoshikawa
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002675:Child, Preschool; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000139:chemically induced* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D009447:Neuroblastoma / Q000188:drug therapy* / Q000473:pathology; D015275:Tumor Lysis Syndrome / Q000188:drug therapy* / Q000209:etiology*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone