4.4 Article

Concomitant Presentation of Hemophagocytic Lymphohistiocytosis and Posttransplant Lymphoproliferative Disease-Like Lymphoma in a Mildly Immunosuppressed Leukemia Patient: An Unusual Association

Journal

PEDIATRIC BLOOD & CANCER
Volume 63, Issue 8, Pages 1474-1476

Publisher

WILEY-BLACKWELL
DOI: 10.1002/pbc.26033

Keywords

acute leukemias; Epstein-Barr virus; HLH; infections in immunocompromised hosts; lymphoproliferative disease

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We describe a 4-year-old female with pre-B-cell acute lymphoblastic leukemia on maintenance chemotherapy, who developed hemophagocytic lymphohistiocytosis (HLH) secondary to Epstein-Barr virus (EBV) infection, complicated by an aggressive lymphoproliferative disorder. Although there was no history of bone marrow transplant or underlying immunodeficiency, EBV triggered a post-transplant lymphoproliferative disease (PTLD)-like lymphoma. Multiple regimens of chemotherapy failed to induce remission and patient developed multiorgan failure. The association of HLH with EBV-related PTLD-like lymphoproliferative disorder is rare. We present this case to highlight this unusual association so that this highly fatal disease can be recognized and promptly addressed. (C) 2016Wiley Periodicals, Inc.

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