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Efficacy of thalidomide in a child with histiocytic sarcoma following allogeneic bone marrow tranplantation for T-ALL

Leukemia volume 17, pages 2056–2057 (2003)Cite this article

TO THE EDITOR

Histiocytic sarcoma is a very rare malignant proliferation and its definition remains controversial.1 The International Lymphoma Study Group published recently a classification.2 According to this classification, our patient presented histiocytic sarcoma defined by CD68+ and CD1a−. Owing to systemic involvement, the diagnosis was consistent with ‘malignant hystiocytosis’. Interestingly, of the 18 cases of granulocytic sarcoma reported by Pileri, three had systemic presentation of the disease and two of whom previously presented acute lymphoblastic leukemia or myelodysplasia. Most histiocytic sarcomas are treated as high-grade non-Hodgkin's lymphomas but the prognosis seems very poor.1,3 The pathogenesis of the histiocytic sarcomas is not well understood. In the case reported here, the etiologic role of the previous ALL and transplantation, or the high immunosuppression level using novel drug as MMF is unknown. The EBV genome was expressed neither by blood cells or by tumor cells. The patient presented a 100% donor chimerism in blood but the exact tumor origin, donor or recipient, remains unknown. Three other cases of histiocytic sarcoma following therapy for lymphoblastic neoplasms were published in one adult and two children. Neither had been transplanted before the diagnosis of histiocytic sarcoma.4 Nevertheless, the histiocytic sarcoma observation is too rare to conclude about the role of previous hematological malignancy, transplantation or intensive immunosuppression on its pathogenesis.

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Authors and Affiliations

  1. Unité Protégée A, Hôpital Jeanne de Flandre, Lille, France

    J H Dalle, P Leblond, B Nelken & F Mazingue

  2. Service d'Anatomie Pathologique, Hôpital Calmette, Lille, France

    A Decouvelaere

  3. Unité de Greffes Médullaires, Service de Maladie du Sang, Hôpital Claude Huriez, Lille, France

    I Yakoub-Agha

  4. Laboratoire d'hématologie, Hôpital Calmette, Lille, France

    C Preudhomme

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  1. J H Dalle
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Dalle, J., Leblond, P., Decouvelaere, A. et al. Efficacy of thalidomide in a child with histiocytic sarcoma following allogeneic bone marrow tranplantation for T-ALL. Leukemia 17, 2056–2057 (2003). https://doi.org/10.1038/sj.leu.2403075

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