Lymphoma-based therapy for refractory or relapsed Epstein–Barr virus–related hemophagocytic lymphohistiocytosis in children

Epstein–Barr virus–related hemophagocytic lymphohistiocytosis (EBV-HLH) is a life-threatening hyperinflammatory syndrome. Although etoposide-based immunochemotherapy has improved survival rates, consensus regarding the appropriate salvage therapy for patients with refractory or relapsed EBV-HLH is l...

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Bibliographic Details
Main Authors: Chao-Neng Cheng, Wei-Ying Chu, Kung-Chao Chang, Jiann-Shiuh Chen
Format: Article
Language:English
Published: Elsevier 2022-11-01
Series:Journal of the Formosan Medical Association
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Online Access:http://www.sciencedirect.com/science/article/pii/S0929664622000092
Description
Summary:Epstein–Barr virus–related hemophagocytic lymphohistiocytosis (EBV-HLH) is a life-threatening hyperinflammatory syndrome. Although etoposide-based immunochemotherapy has improved survival rates, consensus regarding the appropriate salvage therapy for patients with refractory or relapsed EBV-HLH is lacking. We performed a retrospective study to examine the efficacy of a lymphoma-based treatment regimen for children with refractory or relapsed EBV-HLH. The data of six children were analyzed. Four had cytogenetic abnormalities, and two experienced a transition to EBV-positive T-cell lymphoma. They were treated with an intensive chemotherapy regimen modified from that used in the Berlin–Frankfurt–Münster Group Trial as salvage therapy. Five patients (83%) achieved complete response. Four patients (67%) were disease free for a median of 10 years without undergoing allogeneic hematopoietic stem cell transplantation. No grade 3 or 4 nonhematologic adverse events occurred. Lymphoma-based chemotherapy is a potential curative treatment for some subgroups of children with refractory or relapsed EBV-HLH.
ISSN:0929-6646