L-DEP regimen salvage therapy for refractory primary hemophagocytic lymphohistiocytosis triggered by Epstein-Barr virus infection in 4 children

Objective: To analyze the efficacy and safety of the L-DEP regimen (asparaginase, liposome doxorubicin, etoposide and methylprednisolone) as a salvage therapy for the refractory primary hemophagocytic lymphohistocytosis triggered by Epstein-Barr virus infection (EBV-pHLH) in children. Methods: In th...

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Publié dans:Zhonghua er ke za zhi = Chinese journal of pediatrics. - 1960. - 62(2024), 5 vom: 02. Mai, Seite 467-472
Auteur principal: Zhao, Y Z (Auteur)
Autres auteurs: Ma, H H, Lian, H Y, Wang, D, Wang, T Y, Zhang, R
Format: Article en ligne
Langue:Chinese
Publié: 2024
Accès à la collection:Zhonghua er ke za zhi = Chinese journal of pediatrics
Sujets:English Abstract Journal Article Etoposide 6PLQ3CP4P3 Asparaginase EC 3.5.1.1 Doxorubicin 80168379AG Methylprednisolone X4W7ZR7023 plus... UNC13D protein, human PRF1 protein, human Membrane Proteins Perforin 126465-35-8 Liposomes
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245 1 0 |a L-DEP regimen salvage therapy for refractory primary hemophagocytic lymphohistiocytosis triggered by Epstein-Barr virus infection in 4 children 
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520 |a Objective: To analyze the efficacy and safety of the L-DEP regimen (asparaginase, liposome doxorubicin, etoposide and methylprednisolone) as a salvage therapy for the refractory primary hemophagocytic lymphohistocytosis triggered by Epstein-Barr virus infection (EBV-pHLH) in children. Methods: In this retrospective case study, clinical and laboratory data before and after L-DEP regimen of 4 children diagnosed with EBV-pHLH in Beijing Children's hospital between January 2016 and June 2022 were collected, and the efficacy and safety of L-DEP regimen for the treatment of EBV-pHLH were analyzed. Results: Among 4 patients, there were 3 females and 1 male with the age ranged from 0.8 to 7.0 years. Two of them showed compound heterozygous mutations of PRF1, one with a heterozygous mutation of UNC13D, one homozygous mutation of ITK. Before the L-DEP therapy, all of them had anemia and a soaring level of soluble CD25, 3 patients had neutropenia and thrombopenia, 3 patients had a high level of ferritin, 3 patients had hypofibrinogenemia and 1 patient had hypertriglyceridemia. After receiving 1 or 2 cycles of L-DEP treatment, three achieved remission, including complete remission (1 case) and partial remission (2 cases), and the other one had no remission. The levels of blood cell counts, soluble CD25, triglyceride, fibrinogen and albumin were recovered gradually in 3 patients who got remission. All four patients underwent hematopoietic stem cell transplantation (HSCT) after L-DEP regimen, and three survived. All patients had no severe chemotherapy related complications. The main side effects were bone marrow suppression, infection and pancreatitis, which recovered after appropriate treatments, apart from one who died from severe infection after urgent HSCT. Conclusion: L-DEP regimen could be served as an effective and safe salvage treatment for refractory pediatric EBV-pHLH, and also provide an opportunity for patients to receive HSCT 
650 4 |a English Abstract 
650 4 |a Journal Article 
650 7 |a Etoposide  |2 NLM 
650 7 |a 6PLQ3CP4P3  |2 NLM 
650 7 |a Asparaginase  |2 NLM 
650 7 |a EC 3.5.1.1  |2 NLM 
650 7 |a Doxorubicin  |2 NLM 
650 7 |a 80168379AG  |2 NLM 
650 7 |a Methylprednisolone  |2 NLM 
650 7 |a X4W7ZR7023  |2 NLM 
650 7 |a UNC13D protein, human  |2 NLM 
650 7 |a PRF1 protein, human  |2 NLM 
650 7 |a Membrane Proteins  |2 NLM 
650 7 |a Perforin  |2 NLM 
650 7 |a 126465-35-8  |2 NLM 
650 7 |a Liposomes  |2 NLM 
700 1 |a Ma, H H  |e verfasserin  |4 aut 
700 1 |a Lian, H Y  |e verfasserin  |4 aut 
700 1 |a Wang, D  |e verfasserin  |4 aut 
700 1 |a Wang, T Y  |e verfasserin  |4 aut 
700 1 |a Zhang, R  |e verfasserin  |4 aut 
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