Nhân một trường hợp hội chứng thực bào máu thứ phát do u lympho tế bào B lớn lan tỏa

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare fatal clinical syndrome characterized by a hyperinflammatory condition caused by aberrantly activated macrophages and cytotoxic T cells, resulting in a cytokine storm and organ impairment. Lymphoma, especially B-cell lymphoma in Japan, is a common trigger of secondary HLH. In Viet Nam, however, most cases of HLH secondary occur in patients with infection; HLH is relatively uncommon in patients with B-cell non-Hodgkin’s lymphoma. We herein describe a man with diffuse large B-cell lymphoma (DLBCL) and secondary HLH who was successfully treated by R-CHOP chemotherapy. All symptoms resolved and laboratory indications of HLH normalized, and complete remission of the lymphoma was achieved after 4 cycles of R-CHOP. Unfortunately, the patient died due to disease progression at center nevous system after 5^th cycles . This rare case highlights not only the possibility of HLH secondary to DLBCL but also the importance of early initiation of R-CHOP chemotherapy and prophylactic treatment of central nervous system involvement.