TY - JOUR
T1 - Haemophagocytic lymphohistiocytosis occurred during induction chemotherapy in an acute monocytic leukemia patient with FLT3-ITD and DNMT3A mutations
AU - Li, Fei
AU - Zhang, Xiaojie
AU - Wang, Yunyun
AU - Yang, Ailin
AU - Zhang, Zhanglin
AU - Tang, Weiping
AU - Zhong, Nan
AU - Shi, Huidong
N1 - Funding Information:
This work is financially supported by grants from the National Natural Science Foundation of China (81360353, 81560034, 81560036), the Natural Science Foundation of Jiangxi province (20142BAB205072) and the Young Scientist Training Program (20153BCB23040) of Jiangxi Province.
Funding Information:
This work is financially supported by grants from the National Natural Science Foundation of China (81360353, 81560034, 81560036), the Natural Science Foundation of Jiangxi province (20142BAB205072) and the Young Scientist Training Program (20153BCB23040) of Jiangxi Province
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/5/29
Y1 - 2018/5/29
N2 - Background: Haemophagocytic lymphohistiocytosis (HLH) is considered to be a large challenge for clinicians due to the variable overlaps of symptoms with other severe diseases and a high rate of mortality. Prompt diagnosis and treatment are crucial to avoid a fatal outcome. However, very limited reports have focused on HLH during chemotherapy (Ch-HLH) due to a low incidence and insufficient knowledge. Case presentation: A 22-year-old male was diagnosed with acute monocytic leukemia with FLT3-ITD and DNMT3A mutations and pulmonary infection. He received IA regimen (Idarubicin, 8 mg/m2/d for 3 days and cytarabine, 100 mg/m2/d for 7 days) chemotherapy, anti-infection drugs and blood components transfusions. During the stage of bone marrow suppression, he presented with a fever, cytopenia (WBC, 0.43×109/L; Hb, 73 g/L and PLT, 1×109/L), refractory coagulation dysfunction (APTT, 104.0 s; PT, 30.5 s and Fbg, 0.87 g/L), splenomegaly (3 cm below the costal margin), hyperferritinemia (SF>3000 μg/L), increased soluble interleukin-II receptors (sIL-2R>7500 u/mL) and haemophagocytosis in the bone marrow and was diagnosed with HLH. After he was treated with methylprednisolone at 500 mg/d for 3 days, 120 mg/d for 3 days and 80 mg/d for 3 days, followed by a gradually reduced dose combined with powerful anti-infection drugs, his symptoms subsided and his abnormal parameters recovered to normal levels. Conclusion: Patients with HLH in acute leukemia have a high rate of mortality. This case report provides helpful clinical experiences relative to the recognition and treatment of Ch-HLH for clinicians.
AB - Background: Haemophagocytic lymphohistiocytosis (HLH) is considered to be a large challenge for clinicians due to the variable overlaps of symptoms with other severe diseases and a high rate of mortality. Prompt diagnosis and treatment are crucial to avoid a fatal outcome. However, very limited reports have focused on HLH during chemotherapy (Ch-HLH) due to a low incidence and insufficient knowledge. Case presentation: A 22-year-old male was diagnosed with acute monocytic leukemia with FLT3-ITD and DNMT3A mutations and pulmonary infection. He received IA regimen (Idarubicin, 8 mg/m2/d for 3 days and cytarabine, 100 mg/m2/d for 7 days) chemotherapy, anti-infection drugs and blood components transfusions. During the stage of bone marrow suppression, he presented with a fever, cytopenia (WBC, 0.43×109/L; Hb, 73 g/L and PLT, 1×109/L), refractory coagulation dysfunction (APTT, 104.0 s; PT, 30.5 s and Fbg, 0.87 g/L), splenomegaly (3 cm below the costal margin), hyperferritinemia (SF>3000 μg/L), increased soluble interleukin-II receptors (sIL-2R>7500 u/mL) and haemophagocytosis in the bone marrow and was diagnosed with HLH. After he was treated with methylprednisolone at 500 mg/d for 3 days, 120 mg/d for 3 days and 80 mg/d for 3 days, followed by a gradually reduced dose combined with powerful anti-infection drugs, his symptoms subsided and his abnormal parameters recovered to normal levels. Conclusion: Patients with HLH in acute leukemia have a high rate of mortality. This case report provides helpful clinical experiences relative to the recognition and treatment of Ch-HLH for clinicians.
KW - Acute monocytic leukemia
KW - DNMT3A
KW - FLT3-ITD
KW - Haemophagocytic lymphohistiocytosis
KW - Malignancy
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U2 - 10.1186/s12885-018-4534-z
DO - 10.1186/s12885-018-4534-z
M3 - Article
C2 - 29843647
AN - SCOPUS:85047661561
SN - 1471-2407
VL - 18
JO - BMC Cancer
JF - BMC Cancer
IS - 1
M1 - 604
ER -