Alten Julia, Klapper Wolfram, Leuschner Ivo, Eckert Cornelia, Beier Rita, Vallo Elisabeth, Krause Martin, Claviez Alexander, Vieth Simon, Bleckmann Kirsten, Möricke Anja, Schrappe Martin, Cario Gunnar
Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus Kiel, Germany.
Department of Pathology, Lymph Node Registry Kiel, Institute of Hematopathology University Hospital Schleswig-Holstein, Campus Kiel, Germany.
Pediatr Blood Cancer. 2015 Sep;62(9):1656-60. doi: 10.1002/pbc.25523. Epub 2015 Apr 1.
Histiocytic sarcoma (HS) is a rare disease with poor prognosis which may develop subsequent to acute lymphoblastic leukemia (ALL). Here we report two children treated within the AIEOP-BFM ALL 2009 trial: one patient succumbed to fulminant hemophagocytic lymphohistiocytosis triggered by HS during ALL maintenance therapy, the other patient had a smoldering course of HS for over 2 years, and subsequently died after allogeneic stem cell transplantation. In both cases, HS and ALL were clonally related and apparent return of minimal residual disease (MRD) was detected by qPCR in bone marrow. Thus, HS should be considered in ALL when MRD appears to persist or reappear.
组织细胞肉瘤（HS）是一种预后较差的罕见疾病，可能继发于急性淋巴细胞白血病（ALL）。在此，我们报告在AIEOP-BFM ALL 2009试验中接受治疗的两名儿童：一名患者在ALL维持治疗期间死于由HS引发的暴发性噬血细胞性淋巴组织细胞增生症，另一名患者HS病情隐匿发展超过2年，随后在异基因干细胞移植后死亡。在这两个病例中，HS与ALL均为克隆相关，并且通过qPCR在骨髓中检测到微小残留病（MRD）明显复发。因此，当MRD似乎持续存在或再次出现时，ALL患者应考虑患有HS。
