Ishida Y, Yokota Y, Tauchi H, Matusda H
Department of Pediatrics, Ehime University School of Medicine.
Rinsho Ketsueki. 1991 Sep;32(9):970-5.
The patient is 11-year-old girl who was diagnosed as having hybrid acute leukemia (myeloid and lymphoid) from morphological (cytochemistry) findings, immunophenotype and genotype. During reinduction therapy after a second relapse, she presented hepatosplenomegaly and the remittent fever unresponsive to the intensified antibiotics. The diagnosis of reactive histiocytosis was made because of the remarkable elevation of serum ferritin value and proliferation of mature histiocytes in the bone marrow. Treatment with etoposide resulted in the disappearance of her fever and other symptoms. The subsequent refractoriness to platelet transfusion was also overcome by etoposide (p.o.) therapy. The results suggested that the treatment with etoposide might be effective for reactive histiocytosis and the related refractory state to platelet transfusion during therapy for leukemia.
该患者为一名11岁女孩，根据形态学（细胞化学）检查结果、免疫表型和基因型，被诊断为混合性急性白血病（髓系和淋系）。在第二次复发后的再诱导治疗期间，她出现肝脾肿大和弛张热，强化抗生素治疗无效。由于血清铁蛋白值显著升高和骨髓中成熟组织细胞增殖，诊断为反应性组织细胞增多症。依托泊苷治疗使她的发热和其他症状消失。依托泊苷（口服）治疗也克服了随后出现的对血小板输注的难治性。结果表明，依托泊苷治疗可能对反应性组织细胞增多症以及白血病治疗期间相关的血小板输注难治状态有效。
