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Sequential Transplants for Respective Relapse of Hodgkin Disease and Hemophagocytic Lymphohistiocytosis: A Treatment Dilemma

Chang, Yu-Hsiang MD* † ‡; Lu, Pei-Jung PhD§; Lu, Meng-Yao MD; Wang, Jyh-Seng MD, PhD; Tung, Chun-Liang MD; Shaw, Chen-Fu PhD*

Journal of Pediatric Hematology/Oncology: October 2009 - Volume 31 - Issue 10 - pp 778-781
doi: 10.1097/MPH.0b013e3181b38b4e
Clinical and Laboratory Observations

The association of hemophagocytic lymphohistiocytosis (HLH) with Hodgkin disease (HD) seems to be uncommon. A 9-year-old boy, diagnosed with HD-HLH, received chemotherapy and remained in complete remission for 21 months. Then the patient received the first autologous transplant and unfortunately died due to multiorgan failure after the second allogeneic transplant because of sequentially respective relapse of HD and HLH. The recurrence of HLH with a high Epstein-Barr virus load but without relapse of HD in the patient suggests that Epstein-Barr virus may have a major pathogenetic role in the specific disorder HLH-HD. Detailed reports relating to HLH-HD were also reviewed.

Departments of Pediatrics

Pathology, Kaohsiung Veterans General Hospital

*Department of Biological Science, National Sun Yat-Sen University, Kaohsiung

Faculty of Medicine, School of Medicine, National Yang-Ming University

Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei

§Institute of Clinical Medicine, School of Medicine, National Cheng Kung University, Tainan

Department of Pathology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan

Reprints: Chen-Fu Shaw, PhD, Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan (e-mail: yhc@ms3.hinet.net).

Received for publication January 25, 2009

accepted May 13, 2009

© 2009 Lippincott Williams & Wilkins, Inc.