FATAL HEMATOPHAGIC HISTIOCYTOSIS AFTER GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR AND CHEMOTHERAPY FOR HIGH-GRADE MALIGNANT-LYMPHOMA

Fatal hematophagic histiocytosis occurred in two patients after they h ad received granulocyte-macrophage colony-stimulating factor (GM-CSF) in addition to chemotherapy for malignant non-Hodgkin's lymphoma. In o ne patient GM-CSF promoted the activity of subclinical hematophagic hi stiocytosis, resulting in severe pancytopenia and multiorgan failure. In the other patient the syndrome that caused persistent bone marrow f ailure began after the institution of GM-CSF therapy. Exogenous GM-CSF appears to upregulate preexisting hematophagic histiocytosis and may even contribute to its de novo initiation. It is therefore conceivable that endogenous GM-CSF also plays an essential role in the pathogenes is of this syndrome.