Acute promyelocytic leukemia following chemotherapy for EBV-associated hemophagocytic lymphohistiocytosis

Pediatr Blood Cancer. 2011 May;56(5):850-2. doi: 10.1002/pbc.22718. Epub 2011 Jan 16.

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.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Chromosomes, Human, Pair 15 / genetics
  • Chromosomes, Human, Pair 17 / genetics
  • Cyclosporine / administration & dosage
  • Dexamethasone / administration & dosage
  • Epstein-Barr Virus Infections / complications*
  • Epstein-Barr Virus Infections / drug therapy*
  • Epstein-Barr Virus Infections / virology
  • Etoposide / administration & dosage
  • Herpesvirus 4, Human / pathogenicity
  • Humans
  • In Situ Hybridization, Fluorescence
  • Infant
  • Karyotyping
  • Leukemia, Promyelocytic, Acute / chemically induced*
  • Leukemia, Promyelocytic, Acute / diagnosis
  • Leukemia, Promyelocytic, Acute / drug therapy
  • Lymphatic Diseases
  • Lymphohistiocytosis, Hemophagocytic / complications*
  • Lymphohistiocytosis, Hemophagocytic / drug therapy*
  • Lymphohistiocytosis, Hemophagocytic / virology
  • Male
  • Oncogene Proteins, Fusion / genetics
  • Translocation, Genetic / genetics

Substances

  • Oncogene Proteins, Fusion
  • promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein
  • Etoposide
  • Dexamethasone
  • Cyclosporine