Abstract
We report a case of chemotherapy-related acute promyelocytic leukemia (APL) following therapy with VP-16/etoposide for EBV-associated hemophagocytic lymphohistiocytosis (HLH). A 17-month-old male presented with fever and lymphadenopathy. Bone marrow and liver biopsies showed hemophagocytosis. He responded well to chemotherapy including dexamethasone, VP-16/etoposide, and cyclosporine. One and a half year later, he developed fever and pancytopenia. Clinical work-up revealed APL with t(15;17)(q22;q12);PML-RARα translocation. He underwent chemotherapy for APL and is in remission 8 years after diagnosis. Alternative non-leukemogenic agents to effectively treat HLH would be desirable.
Copyright © 2011 Wiley-Liss, Inc.
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / adverse effects*
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Chromosomes, Human, Pair 15 / genetics
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Chromosomes, Human, Pair 17 / genetics
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Cyclosporine / administration & dosage
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Dexamethasone / administration & dosage
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Epstein-Barr Virus Infections / complications*
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Epstein-Barr Virus Infections / drug therapy*
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Epstein-Barr Virus Infections / virology
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Etoposide / administration & dosage
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Herpesvirus 4, Human / pathogenicity
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Humans
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In Situ Hybridization, Fluorescence
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Infant
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Karyotyping
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Leukemia, Promyelocytic, Acute / chemically induced*
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Leukemia, Promyelocytic, Acute / diagnosis
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Leukemia, Promyelocytic, Acute / drug therapy
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Lymphatic Diseases
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Lymphohistiocytosis, Hemophagocytic / complications*
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Lymphohistiocytosis, Hemophagocytic / drug therapy*
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Lymphohistiocytosis, Hemophagocytic / virology
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Male
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Oncogene Proteins, Fusion / genetics
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Translocation, Genetic / genetics
Substances
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Oncogene Proteins, Fusion
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promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein
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Etoposide
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Dexamethasone
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Cyclosporine