title: Risk for complications in patients with hemophagocytic lymphohistiocytosis who undergo hematopoietic stem cell transplantation: myeloablative versus reduced-intensity conditioning regimens.
abstract: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative option for patients with primary hemophagocytic lymphohistiocytosis (HLH) and for patients with secondary HLH who fail to respond to therapy. Advances in HSCT and supportive care measures have resulted in improved patient outcomes and decreased treatment-related mortality. Despite the overall improvement in outcome, HLH patients who undergo HSCT using myeloablative conditioning regimens are still at significant risk for complications. The HLH-94 study conducted by the Histiocyte Society reported a 30% TRM with increased pulmonary and hepatic complications. Recently, the use of reduced-intensity conditioning (RIC) regimens has shown favorable outcomes when compared to conventional HSCT and lower rate of acute complications. In this review we compare the potential complications of myeloablative and RIC regimens for HSCT in HLH patients.
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Tal
authors.initials: T
authors.lastname: Schechter
authors.forename: Ahmed
authors.initials: A
authors.lastname: Naqvi
authors.forename: Sheila
authors.initials: S
authors.lastname: Weitzman
mesh_terms: D002648:Child; D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D012306:Risk; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D019653:Myeloablative Agonists
keywords: BMT; children; complications; hemophagocytic lymphohistiocytosis