Hemophagocytosis in acute myeloid leukemia

Morales-Olvera, Claudia; Pérez-Jacobo, Fernando

doi:10.1016/j.htct.2023.08.001

Hematology, Transfusion and Cell Therapy

ISSN: 2531-1379

Hematology, Transfusion and Cell Therapy is a quarterly scientific publication of the Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH), Associazione Italo-Brasiliana di Ematologia (AIBE), Eurasian Hematology Oncology Group (EHOG), and Sociedade Brasileira de Oncologia Pediátrica (SOBOPE).

Hematology, Transfusion and Cell Therapy publishes original articles, review articles and case reports covering various areas in the field of hematology and hemotherapy. The journal was previously published, until 2016, as Revista Brasileira de Hematologia e Hemoterapia.

ISSN print: 2531-1379
ISSN online: 2531-1387

Published by Elsevier Editora Ltda, Rio de Janeiro, Brazil.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management.

Indexed in:

Web of Science, LILACS, SciELO Brazil, ESCI (Web of Science), Scopus, and PubMed/PMC

A 63-year-old man with acute myeloid leukemia (AML) and treated with venetoclax and azacytidine, presented to the emergency department with fever, shortness of breath and gum bleeding. Laboratory evaluation showed pancytopenia; prolonged thrombin time with hypofibrinogenemia, elevated D-dimer and hyperferritinemia (29,000 µg/ L). Bone marrow smear revealed blastic infiltration with hemophagocytosis by histiocytes (panel A), macrophages (Panel B) and blasts (Panels C and D), (Figure 1).

Figure 1.

Bone marrow aspirate showing hemophagocytosis by (A) histiocytes, (B) macrophages and (C, D) infiltration with hemophagocytosis by monocytic blasts (Wright-Giemsa stain, 100x).

(0.46MB).

Salvage chemotherapy was initiated, but the patient died 28 days after presentation. Hemophagocytic lymphohistiocytosis can be diagnosed in up to 10% of patients with AML,1 and is associated with poor outcomes.1,2

References

[1]

K. Delavigne, E. Bérard, S. Bertoli, J. Corre, E. Duchayne, C. Demur, et al.

Hemophagocytic syndrome in patients with acute myeloid leukemia undergoing intensive chemotherapy.

Haematologica, 99 (2014), pp. 474-480

http://dx.doi.org/10.3324/haematol.2013.097394 | Medline

[2]

K. Hatano, T. Nagai, T. Matsuyama, Y. Sakaguchi, S. Fujiwara, I. Oh, et al.

Leukemia cells directly phagocytose blood cells in AML-associated hemophagocytic lymphohistiocytosis: a case report and review of the literature.

Acta Haematol, 133 (2015), pp. 98-100

http://dx.doi.org/10.1159/000360840 | Medline