Kounami Shinji, Nakayama Keiko, Yoshiyama Megumi, Rikoh Mitsuhiko, Watanabe Takashi, Takifuji Katsuya, Yoshikawa Norishige
Department of Pediatrics, Wakayama Medical University, Kimiidera Wakayama City, Japan.
Pediatr Hematol Oncol. 2012 Feb;29(1):99-103. doi: 10.3109/08880018.2011.643529.
The authors report the clinical course of a 3-year-old boy with stage 4 neuroblastoma (NB) complicated by hemophagocytic lymphohistiocytosis (HLH) immediately after the start of chemotherapy. The NB responded very well to the chemotherapy, but the patient developed high fever on the 2nd day, and was diagnosed as having HLH of the 7th day of chemotherapy. No infections were demonstrated, and massive tumor cell destruction resulting from the rapid effect of chemotherapy was thought to be a cause of systemic cytokine response, resulting in HLH. Methylprednisolone pulse therapy was effective for the HLH, which did not recur thereafter. HLH should be recognized as a serious adverse event during chemotherapy for advanced NB that has a large malignant cell load.
作者报告了一名3岁患有4期神经母细胞瘤（NB）的男孩在化疗开始后立即并发噬血细胞性淋巴组织细胞增生症（HLH）的临床过程。该NB对化疗反应非常好，但患者在第2天出现高热，并在化疗第7天被诊断为HLH。未发现感染，化疗的快速作用导致大量肿瘤细胞破坏被认为是全身细胞因子反应的一个原因，从而导致HLH。甲基强的松龙脉冲疗法对HLH有效，此后未再复发。HLH应被视为晚期NB化疗期间的一种严重不良事件，这类NB具有大量恶性细胞负荷。
