The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
Requirement for Etoposide in the Treatment of Epstein-Barr Virus–Associated Hemophagocytic Lymphohistiocytosis
Abstract
PURPOSE: We sought to identify the clinical variables most critical to successful treatment of Epstein-Barr virus (EBV)–associated hemophagocytic lymphohistiocytosis (HLH). PATIENTS AND METHODS: Among the factors tested were age at diagnosis (< 2 years or ≥ 2 years), time from diagnosis to initiation of treatment with or without etoposide-containing regimens, timing of cyclosporin A (CSA) administration during induction therapy, and the presence or absence of etoposide. RESULTS: By Kaplan-Meier analysis, the overall survival rate for the entire cohort of 47 patients, most of whom had moderately severe to severe disease, was 78.3% ± 6.7% (SE) at 4 years. The probability of long-term survival was significantly higher when etoposide treatment was begun less than 4 weeks from diagnosis (90.2% ± 6.9% v 56.5% ± 12.6% for patients receiving this agent later or not at all; P < .01, log-rank test). Multivariate analysis with the Cox proportional hazards model demonstrated the independent prognostic significance of a short interval from EBV-HLH diagnosis to etoposide administration (relative risk of death for patients lacking this feature, 14.1; 95% confidence interval, 1.16 to 166.7; P = .04). None of the competing variables analyzed had significant predictive strength in the Cox model. However, concomitant use of CSA with etoposide in a subset of patients appears to have prevented serious complications from neutropenia during the first year of treatment. CONCLUSION: We conclude that early administration of etoposide, preferably with CSA, is the treatment of choice for patients with EBV-HLH.
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Cites
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Epstein-Barr virus-infected T lymphocytes in Epstein-Barr virus-associated hemophagocytic syndrome.
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Self-citationTherapeutic Plasma Exchange: An Update from the Canadian Apheresis Group
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Hemophagocytic lymphohistiocytosis in infancy and childhood
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Self-citationPullen, J., Shuster, J. J., Link, M. P., Borowitz, M. J., Amylon, M. D., Carroll, A. J., Land, V. J., Look, A. T., McIntyre, B. C., & Camitta, B. M. (1999) · Leukemia · doi:10.1038/sj.leu.2401555 · Cited by 138
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Immunomodulation treatment for childhood virus‐associated haemophagocytic lymphohistiocytosis
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Self-citationMatsumoto, Y., Naniwa, D., Banno, S., & Sugiura, Y. (1998) · Therapeutic Apheresis and Dialysis · doi:10.1111/j.1744-9987.1998.tb00127.x · Cited by 85
Cited by
Adult haemophagocytic syndrome
Ramos-Casals, M., Brito-Zerón, P., López-Guillermo, A., Khamashta, M. A., & Bosch, X. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61048-x · Cited by 1,442
Prognostic Factors and Outcomes of Adults With Hemophagocytic Lymphohistiocytosis
Parikh, S. A., Kapoor, P., Letendre, L., Kumar, S., & Wolanskyj, A. P. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2013.12.012 · Cited by 323
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Metadata
- Authors
- Imashuku, S., Kuriyama, K., Teramura, T., Ishii, E., Kinugawa, N., Kato, M., Sako, M., & Hibi, S.
- Venue
- Journal of Clinical Oncology
- Published
- 2001-05-15
- Volume
- 19
- Issue
- 10
- Pages
- 2665-2673
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2103155822
- Cited by
- 286
- References
- 17
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- closed
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- Imashuku, S., Kuriyama, K., Teramura, T., Ishii, E., Kinugawa, N., Kato, M., Sako, M., & Hibi, S. (2001). Requirement for Etoposide in the Treatment of Epstein-Barr Virus–Associated Hemophagocytic Lymphohistiocytosis. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2001.19.10.2665
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