International Journal of Hematology

, Volume 75, Issue 2, pp 174–177 | Cite as

Risk of Etoposide-Related Acute Myeloid Leukemia in the Treatment of Epstein-Barr Virus—Associated Hemophagocytic Lymphohistiocytosis

  • Shinsaku ImashukuEmail author
  • Tomoko Teramura
  • Kikuko Kuriyama
  • Junichi Kitazawa
  • Etsuro Ito
  • Akira Morimoto
  • Shigeyoshi Hibi
Progress in Hematology


We studied the impact of etoposide on the prognosis of 81 patients (77 of whom were children <15 years old) with Epstein-Barr virus—associated hemophagocytic lymphohistiocytosis (EBV-HLH).The study group received a median cumulative dose of 1500 mg/m2 etoposide (range, 0–14,550 mg/m2), with a median follow-up period of 44 months (range, 20–88 months) from the diagnosis. Only 1 patient, who received 3150 mg/m2 etoposide, developed therapy-related acute myeloid leukemia (t-AML), at 31 months after diagnosis. Excluding 9 patients who underwent hemopoietic stem cell transplantation during the course of treatment, the prognosis was poorer for those patients who received less than a 1000 mg/m2 cumulative dose of etoposide. Our results indicate that the risk of etoposide-related t-AML is low. An appropriate dosage of etoposide for the treatment of EBV-HLH would be in the range of 1000 to 3000 mg/m2. However, even at these doses, care must be taken to prevent the rare risk of t-AML.

Key words

Hemophagocytic lymphohistiocytosis Epstein-Barr virus Etoposide Therapy-related myeloid leukemia 


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Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Shinsaku Imashuku
    • 1
    Email author
  • Tomoko Teramura
    • 1
    • 2
  • Kikuko Kuriyama
    • 2
  • Junichi Kitazawa
    • 3
  • Etsuro Ito
    • 3
  • Akira Morimoto
    • 2
  • Shigeyoshi Hibi
    • 2
  1. 1.Kyoto City Institute of Health and Environmental SciencesKyoto
  2. 2.Department of PediatricsKyoto Prefectural University of MedicineKyoto
  3. 3.Department of PediatricsHirosaki University School of MedicineAomoriJapan

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