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Post-transplant Complications

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

Bone Marrow Transplantation volume 49, pages 254–257 (2014)Cite this article

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Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease of severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages that secrete high amounts of inflammatory cytokines. HLH occurring after SCT is difficult to diagnose. It is characterized by severe clinical manifestations and high mortality. Despite current therapeutic approaches, outcomes remain poor. We analyzed the incidence and risk factors of HLH after SCT and the response to treatment and prognosis of 554 patients with HLH after SCT. The cumulative incidence of HLH after SCT was 4.3% (24/554). Use of etoposide in the conditioning regimen was only factor that reduced HLH after SCT (P=0.027). All patients who received autologous transplantation were successfully treated. Patients with liver dysfunction (for example, high total bilirubin level, prolonged prothrombin time and high level of fibrinogen degradation products) had a poor response to treatment for HLH. Physicians should be cautious of HLH, while not using etoposide for conditioning regimen.

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Authors and Affiliations

  1. Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan

    R Kobayashi

  2. Stem Cell Transplantation Center, Hokkaido University Hospital, Sapporo, Japan

    J Tanaka & S Hashino

  3. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    S Ota

  4. Third Department of Internal Medicine, Asahikawa Medical College, Asahikawa, Japan

    Y Torimoto

  5. Department of Hematology, Asahikawa City Hospital, Asahikawa, Japan

    Y Kakinoki

  6. Department of Hematology, Sapporo City General Hospital, Sapporo, Japan

    S Yamamoto

  7. Department of Hematology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan

    M Kurosawa

  8. Department of Pediatrics, Sapporo Medical College, Sapporo, Japan

    N Hatakeyama

  9. Department of Hematology, KKR Sapporo Medical Center, Tonan Hospital, Sapporo, Japan

    Y Haseyama

  10. Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan

    H Sakai

  11. Department of Hematology, Hokkaido P.W.F.A.C Asahikawa-Kosei General Hospital, Asahikawa, Japan

    K Sato

  12. Department of Palliative Care Medicine, Hokkaido P.W.F.A.C Sapporo-Kosei General Hospital, Sapporo, Japan

    T Fukuhara

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  1. R Kobayashi
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  2. J Tanaka
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  3. S Hashino
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  6. Y Kakinoki
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  9. N Hatakeyama
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  10. Y Haseyama
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  11. H Sakai
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  12. K Sato
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  13. T Fukuhara
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Correspondence to R Kobayashi.

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Kobayashi, R., Tanaka, J., Hashino, S. et al. Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT. Bone Marrow Transplant 49, 254–257 (2014). https://doi.org/10.1038/bmt.2013.145

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  • DOI: https://doi.org/10.1038/bmt.2013.145

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