Anaplastic Large-Cell Lymphoma With Leukemoid Reaction

El-Osta, Hazem; Salyers, William; Palko, William; Hagan, Margaret; El-Haddad, Boutros; Schulz, Thomas

doi:10.1200/jco.2008.17.3906

Cited by 8 publications

(9 citation statements)

References 6 publications

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“…7 Extreme leucocytosis has been rarely described in ALCL. 7,8 In a case report by Sueki et al, high levels of Interleukin-17 were found in an adult with ALCL who had presented with extreme leucocytosis and died due to Satish G et al Int J Contemp Pediatr. 2016 Feb;3(1): [294][295][296] International Journal of Contemporary Pediatrics | January-March 2016 | Vol 3 | Issue 1 Page 296 multiorgan dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Anaplastic large cell lymphoma: a rare cause of extreme neutrophilia in a child

Satish

Srinivasan

Varghese

et al. 2016

Int J Contemp Pediatr

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CASE REPORTA three year old boy was admitted to our hospital with history of high grade continuous fever of three weeks duration with no associated symptoms. He had been admitted in two other hospitals prior and had been administered multiple intravenous antibiotics. There was no significant past history. Examination revealed an ill looking child with pallor, icterus, presence of small cervical and axillary lymphadenopathy (1x1 cm), hepatosplenomegaly with polyserositis manifesting as moderate ascites and bilateral pleural effusion. There was no rash or arthritis. Initial investigations included haemoglobin 90 grams/L with positive direct coombs test, white blood cell (WBC) counts 20.7 x 10 9 /cu.mm with 80% polymorphs and platelet count 5 lakhs/cu.mm. The liver function tests (LFT) showed total bilirubin of 4 mg/dl with indirect fraction 2 mg/dl, normal enzymes and albumin 25 gram/L. The renal functions were normal. He had erythrocyte sedimentation rate (ESR) of 70 mm/hour and C-reactive protein of 80 mg/L. There was no organism isolated in blood culture and work up for common infections like enteric fever, malaria; leptospirosis and scrub typhus were negative. Broad spectrum antibiotics were started. Antinuclear antibody test was negative. Skiagram of the chest showed bilateral ABSTRACT Anaplastic large cell lymphoma (ALCL) in children can present with a broad spectrum of clinical manifestations which apart from nodal and extra nodal disease include paraneoplastic phenomena that can mimic an infection or inflammatory illness leading to delayed diagnosis. The following case report describes a child with prolonged fever, hepatosplenomegaly, polyserositis and extreme neutrophilia masquerading as an infection or inflammatory disorder for long before the definitive diagnosis of ALCL was made. This case highlights the rare paraneoplastic phenomena in ALCL and the heightened need to suspect this disorder when the search for underlying infections and connective tissue disorders are not conclusive.

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Section: Discussionmentioning

confidence: 99%

Anaplastic large cell lymphoma: a rare cause of extreme neutrophilia in a child

Satish

Srinivasan

Varghese

et al. 2016

Int J Contemp Pediatr

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“…Instead, patients reveal a high WBC count predominantly consisting of neutrophil granulocytes. Previous literature has reported a few select cases of this subtype (11–15) with ages ranging from 10 to 64 years (median 61 years). These patients comprised two men and three women.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical course is highly aggressive. Four patients died of the disease shortly after diagnosis or presentation, within the range of a few days to 6 months (11, 13–15).…”

Section: Discussionmentioning

confidence: 99%

“…The overall 5‐year survival rate is approximately 70–80% in ALCL, ALK+, and 33–49% in ALCL, ALK− (7, 9, 10). However, a certain group of ALCLs is highly aggressive, carrying even poorer prognosis (11–15). Clinicians frequently initially misdiagnose these patients as having an inflammatory disease rather than lymphoma due to the presence of neutrophilia.…”

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confidence: 99%

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Anaplastic large cell lymphoma with paraneoplastic leukocytosis: a clinicopathological analysis of five cases

Chang

Chen

et al. 2011

Apmis

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Anaplastic large cell lymphoma (ALCL) is a type of T-cell lymphoma with a relatively favorable prognosis. However, a certain group of ALCLs is highly aggressive, featuring paraneoplastic leukocytosis (PL) in clinical presentation. The present study evaluated five cases of ALCL presenting with PL, including four men and one woman, with a median age of 58 years. All cases revealed leukocytosis with a range from 15.3 to 112.9 × 10(3) /μL. Five (100%) and 4 (80%) cases demonstrated immunoreactivity for granulocyte-colony-stimulating factor (G-CSF) and tumor necrosis factor-alpha (TNF-α), respectively. There were significant differences in the expression of G-CSF and TNF-α between ALCL cases with or without PL (p < 0.05 for both). The prognosis of ALCL patients with PL was poor. Four of five patients (80%) died of the disease within a median survival time of 3.5 weeks. The release of G-CSF and TNF-α from lymphoma cells may associate with ALCL presenting with PL, leading to cytokine crisis and even poorer prognosis.

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“…It is likely that various cytokines produced by tumor cells, including granulocyte colony‐stimulating factor (G‐CSF), granulocyte‐macrophage colony‐stimulating factor and IL‐6, may underlie the pathogenesis of leukemoid reactions 6. Three adult and one pediatric anaplastic large cell lymphoma patients with leukemoid reaction and high G‐CSF levels have been reported 15; most of the patients had a very aggressive course of disease, which was possibly due to a systemic inflammatory response. Since our patient had severe bone pains, without bone or bone marrow involvement, we speculate that this might be a cytokine secreting lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Hodgkin lymphoma presenting with pulmonary nodules and leukemoid reaction

Kalra

Dinand

Anupam

et al. 2010

Pediatric Blood & Cancer

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An 8-year-old female presented with fever and severe pain in the hipbones and legs for 2(1/2) months. Investigations revealed a leukemoid reaction and bilateral diffuse nodular opacities on chest X-ray. Supraclavicular lymph node biopsy was diagnostic of Hodgkin lymphoma (HL), mixed cellularity. Both pulmonary nodules and leukemoid reaction being present in the same patient with HL has not been reported.

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Anaplastic Large-Cell Lymphoma With Leukemoid Reaction

Cited by 8 publications

References 6 publications

Anaplastic large cell lymphoma: a rare cause of extreme neutrophilia in a child

Anaplastic large cell lymphoma: a rare cause of extreme neutrophilia in a child

Anaplastic large cell lymphoma with paraneoplastic leukocytosis: a clinicopathological analysis of five cases

Pediatric Hodgkin lymphoma presenting with pulmonary nodules and leukemoid reaction

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