Alemtuzumab-based therapy for Secondary Malignant Histiocytosis arising from Pre-B-ALL. (2018)

• Record Type: Journal Article
• Authors: Abid, Muhammad Bilal; Wadhera, Karan; Bird, Jenny M.; Pawade, Joya; Marks, David I.
• Is Part Of: Leukemia research reports. Volume 9(2018)
• Page Start: 5
• Page End: 8
• Publication Date: 2018
• Subjects: Secondary Malignant Histiocytosis (SMH) -- Pre-B-Cell Acute Lymphoblastic Leukemia (Pre-B-ALL) -- Transdifferentiation -- C/EBPα -- PAX5; Leukemia -- Periodicals; Lymphomas -- Periodicals; Multiple myeloma -- Periodicals; Leukemia -- Periodicals; Lymphoma -- Periodicals; Multiple Myeloma -- Periodicals; Hematologic Neoplasms -- Periodicals; Leukemia; Lymphomas; Multiple myeloma; Electronic journals; Periodicals; 616.9941905
• DOI: 10.1016/j.lrr.2017.11.003
• Languages: English
• ISSNs: 2213-0489

Abstract

Abstract : Clinical Practice Points: Secondary Malignant Histiocytosis (SMH) is an exceedingly rare, life-threatening condition that invariably occurs in the presence of an underlying monoclonal hematologic disorder. Prognosis of SMH remains dismal and there is no established treatment. We report a case of a patient who developed SMH during induction chemotherapy for his underlying pre-B-ALL, that caused persistently high fevers and was only diagnosed by a marrow while cytopenic in phase 2 induction. He was treated with alemtuzumab-based therapy that reduced the histiocytic infiltration of the bone marrow from 80% to 15% and made him eligible to undergo T-cell replete allogeneic stem transplantation from his sibling. This report is the first to highlight the role of alemtuzumab, an anti-CD52 monoclonal antibody, in clonal disorders originating from transdifferentiation. The alemtuzumab-based regimen should be reserved only for carefully selected allogeneic transplant patients.