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Hemophagocytic Lymphohistiocytosis Due to Acute Myeloid Leukemia Relapse: A Very Unusual Association

Maya Belhadj, Barbara Burroni, Felipe Suarez, Frederic Pene, Nicolas Chapuis, Sylvain Pilorge, Lise Willems, Patricia Franchi, Bénédicte Deau, Didier Bouscary, Jerome Tamburini and Marielle Le Goff

Hemophagocytic lymphohistiocytosis (HLH) diagnosed in the course of acute myeloid leukemia (AML) is generally triggered by treatment-induced infections. AML-induced HLH is a very rare situation for which no diagnostic or therapeutic guidelines are available. We report the occurrence of HLH in an AML5 post-transplant relapse. In our case, the absence of detectable pathogen and the parallel evolution between HLH and leukemia burden suggested a direct link between AML and HLH. We suggest that the diagnostic of AML-related HLH should be promptly considered in front of unexplained fever, cytopenia, liver dysfunction or neurological symptoms as therapeutic intervention is urgent in this life-threatening situation.