1997年
Treatment of fulminant hemophagocytic lymphohistiocytosis with combined administration of OKT-3 and etoposide
INTERNATIONAL JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY
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- 巻
- 4
- 号
- 4
- 開始ページ
- 433
- 終了ページ
- 439
- 記述言語
- 英語
- 掲載種別
- 出版者・発行元
- HARWOOD ACAD PUBL GMBH
We reported a case of life-threatening hemophagocytic lymphohistiocytosis (HLH) treated with etoposide and anti-CD3 monoclonal antibody (OKT-3). A 3-year-old boy with fulminant HLH, characterized by CD3(+) CD56(-) atypical lymphocytosis and hemophagocytosis in peripheral blood and bone marrow, whose disease was refractory to conventional therapies including glucocorticoids, cyclosporine A, a small dose of etoposide and plasma exchange, was treated with a combination therapy of OKT-3 and etoposide. Analysis of mononuclear cells for clonality was performed. DNA derived from Epstein-Barr virus, herpes virus-6 and cytomegalovirus was also detected in mononuclear cells from the patient. The plasma cytokine levels were serially evaluated. By DNA analyses, monoclonal proliferation of T cells and a monoclonal population of cells containing the Epstein-Barr virus genome was demonstrated. With administration of two doses of 5 mg/m(2) of OKT-3 combined with 100 mg/m(2) of etoposide, atypical lymphocytes rapidly disappeared, and hematopoietic reconstitution was seen with disappearance of activated macrophages in the bone marrow 7 days after OKT-3 administration. Consistent overproduction of IL-10 through the clinical course was observed. Combined administration of OKT-3 with etoposide was effective in this patient. It seems appropriate to try this therapy for fulminant HLH refractory to conventional therapies.
- リンク情報
- ID情報
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- ISSN : 1070-2903
- Web of Science ID : WOS:A1997YE85300014