Macrophage
activation syndrome (MAS) is linked to inappropriate stimulation of macrophage
cells in the bone marrow and lymphoid system, resulting in abnormal phagocytosis of figurative blood elements and the release of pro-inflammatory cytokines. It is a rare and
serious hyper-inflammatory condition of diagnostic and therapeutic
emergency. MAS is characterized by non-specific clinical and laboratory signs
associated with images of hemophagocytosis. MAS is either “primary” (familial
or pediatric forms), or “secondary/reactive”
to infection, neoplasia, or autoimmune disease. Hemopathies dominate MAS
secondary to neoplasia. B-type acute lymphoblastic leukemia (ALL) is a
hematological malignancy characterized by the proliferation and accumulation of
B lymphoid progenitors, blocked at an early stage of differentiation, leading to suppression of polyclonal
hematopoiesis and subsequent development of signs associated with bone marrow
failure. In this context, we report the observation of a macrophage
activation syndrome (MAS) associated with ALL, diagnosed at H？pital Principal
de Dakar/Senegal, in a 69-year-old patient with awell-controlled type 2
diabetes under oral antidiabetic therapy (OAD) and good general condition.
References
[1]
Berrady, R. and Bono, W. (2014) Lymphohistiocytic Activation Syndrome (SALH). French Annals of Anesthesia and Intensive Care, 33, 26-32. https://doi.org/10.1016/j.annfar.2013.11.026
[2]
George, M.R. (2014) Hemophagocytic Lymphohistiocytosis: Review of Etiologies and Management. Journal of Blood Medicine, 5, 62-86. https://doi.org/10.2147/JBM.S46255
[3]
Ishii, E., Ohga, S., Imashuku, S., Yasukawa, M., Tsuda, H., Miura, I., Yamamoto, K., et al. (2007) Nationwide Survey of Hemophagocytic Lymphohistiocytosis in Japan. International Journal of Hematology, 86, 58-65. https://doi.org/10.1532/IJH97.07012
[4]
Ghita, E., Ilham, K., Raja, N., Hicham, Y., Mohammed, C. and Sanae, S. (2021) SAM Revealing Hodgking Lymphoma: About a Case. Annales de Biologie Clinique, 79, 345-348. https://doi.org/10.1684/abc.2021.1655
[5]
Martinaud, C., Cournac, J.M., Pons, S., Gallard, T., Darles, C., de Jaureguiberry, J.P. and Brisou, P. (2011) Macrophage Activation Syndrome as the Presenting Feature of a Hodgkin’s Lymphoma in an Elderly Patient. Revue de Medecine Interne, 32, e15-e17. https://doi.org/10.1016/j.revmed.2010.03.460
[6]
Huguet, F. and Tavitian, S. (2016) Acute Lymphoblastic Leukemia in Adults. Correspondence in Onco-Hematology, 11.
[7]
Benzineb, B., Bouayed, B., Mesli, N., Taoussi, S., Lamraoui, F., Abad, M.T., et al. (2016) Results of Treatment of Acute Lymphoblastic Leukemia (ALL) in Adults Using the GRAALL 2005 Protocol. Revue Algérien d’Hématologie, No. 12.
[8]
Stéphan, J.L., Koné-Paut, I., Galambrun, C., Mouy, R., Bader-Meunier, B. and Prieur, A.M. (2001) Reactive Haemophagocytic Syndrome in Children with Inflammatory Disorders. A Retrospective Study of 24 Patients. Rheumatology (Oxford), 40, 1285-1292. https://doi.org/10.1093/rheumatology/40.11.1285
[9]
Henter, J.I., Horne, A., Aricó, M., Egeler, R.M., Filipovich, A.H., Imashuku, S., et al. (2007) HLH-2004: Diagnostic and Therapeutic Guidelines for Hemophagocytic Lymphohistiocytosis. Pediatric Blood & Cancer, 48, 124-131. https://doi.org/10.1002/pbc.21039
[10]
Karras, A. and Hermine, O. (2002) Hemophagocytic Syndrome. La Revue de Médecine Interne, 23, 768-778. https://doi.org/10.1016/S0248-8663(02)00673-2
[11]
Shimazaki, C., Inaba, T. and Nakagawa, M. (2000) B-Cell Lymphoma-Associated Hemophagocytic Syndrome. Leukemia & Lymphoma, 38, 121-130. https://doi.org/10.3109/10428190009060325
[12]
Machaczka, M., Vaktnäs, J., Klimkowska, M. and Hägglund, H. (2011) Malignancy-Associated Hemophagocytic Lymphohistiocytosis in Adults: A Retrospective Population-Based Analysis from a Single Center. Leukemia & Lymphoma, 52, 613-619. https://doi.org/10.3109/10428194.2010.551153
[13]
Sow, A., Keita, Y., Touré, S.A., Sall, A., Sarr, M.L., Ouattara, A., Akondé, F.B., et al. (2017) Secondary Macrophage Activation Syndrome in Children: Report of 5 Senegalese Cases. Médecine d’Afrique Noire, 64.
[14]
Sall, A., Akonde, F.B., Sall, F.B., et al. (2015) Hemophagocytic Syndrome and Acute Myeloid Leukemia. Pediatric Hematology and Oncology, 3, 221-223.
[15]
Becheur, M., Jarraya, S., Saada, V., Brini, I., Mrad, K., Boussetta, K., et al. (2015) Pure Erythroblastic Leukemia Associated with Macrophage Activation Syndrome about a Case. Journal Africain du Cancer, 7, 263-268. https://doi.org/10.1007/s12558-015-0401-x
[16]
Papo, T. (2011) Hemophagocytic Syndrome, Macrophage Activation Syndrome. EMC—Traité de Médecine AKOS, 14, 1-8. https://doi.org/10.1016/S1634-6939(11)56293-3
[17]
Fardet, L., Galicier, L., Vignon-Pennamen, M.D., Regnier, S., Noguera, M.E., de Labarthe, A., et al. (2010) Frequency, Clinical Features and Prognosis of Cutaneous Manifestations in Adult Patients with Reactive Haemophagocytic Syndrome. British Journal of Dermatology, 162, 547-553. https://doi.org/10.1111/j.1365-2133.2009.09549.x
[18]
Baranger, L., Cuccuini, W., Lefebvre, C., Luquet, I., Perot, C., Radford, I. and Lafage-Pochitaloff, M. (2016) Cytogenetics in the Management of Children and Adult Acute Lymphoblastic Leukemia (ALL): An Update by the Groupe Francophone de Cytogénétique Hématologique (GFCH). Annales de Biologie Clinique, 74, 547-560. https://doi.org/10.1684/abc.2016.1176
[19]
Crayne, C.B., Albeituni, S., Nichols, K.E. and Cron, R.Q. (2019) The Immunology of Macrophage Activation Syndrome. Frontiers in Immunology, 10, Article No. 119. https://doi.org/10.3389/fimmu.2019.00119
[20]
Fajgenbaum, D.C. and June, C.H. (2020) Cytokine Storm. The New England Journal of Medicine, 383, 2255-2273. https://doi.org/10.1056/NEJMra2026131
