Farias MG, Freitas PAC, Spagnol F, Souza MVD, Alegretti AP, Riegel M, Taniguchi ANR, Daudt LE. HEMOPHAGOCYTOSIS BY BLASTS IN A CHILD WITH ACUTE MONOCYTIC LEUKEMIA AFTER CHEMOTHERAPY.
ACTA ACUST UNITED AC 2020;
39:e2019290. [PMID:
32638943 PMCID:
PMC7333940 DOI:
10.1590/1984-0462/2021/39/2019290]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/09/2019] [Indexed: 11/22/2022]
Abstract
Objective:
To describe the case of a child who presented hemophagocytic
lymphohistiocytosis (HLH) associated with acute monocytic leukemia after
chemotherapy, with hemophagocytosis caused by leukemic cells.
Case description:
In a university hospital in Southern Brazil, a 3-year-old female was
diagnosed with acute monocytic leukemia with normal karyotype. The
chemotherapy regimen was initiated, and she achieved complete remission six
months later, relapsing after four months with a complex karyotype involving
chromosomes 8p and 16q. The bone marrow showed vacuolated blasts with a
monocytic aspect and evidence of hemophagocytosis. The child presented
progressive clinical deterioration and died two months after the
relapse.
Comments:
HLH is a rare and aggressive inflammatory condition characterized by
cytopenias, hepatosplenomegaly, fever, and hemophagocytosis in the bone
marrow, lymph nodes, spleen, and liver. Although rare, malignancy-associated
HLH (M-HLH) is fatal. The patient in this case report met five out of the
eight established criteria for HLH. The evolution of the patient’s
karyotype, regardless of the diagnostic profile, seemed secondary to the
treatment for acute monocytic leukemia. In this case, the cytogenetic
instability might have influenced the abnormal behavior of leukemic cells.
This is a rare case of HLH in a child with acute monocytic leukemia.
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