{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:53:52Z","timestamp":1784098432432,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T00:00:00Z","timestamp":1521936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>HLH occurring after HSCT is a relatively rare disease. Many conditions may mimic or trigger <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> in post\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> period (eg, cytokine release syndrome, engraftment syndrome, graft rejection\/failure, acute graft\u2010vs\u2010host disease, infections systemic inflammatory response syndrome\/sepsis, and thrombotic microangiopathy). Moreover, this period is usually marked by febrile illness, cytopenia, and a \u201ccytokine storm\u201d leading to elevation of inflammatory biomarkers like ferritin and <jats:styled-content style=\"fixed-case\">sCD<\/jats:styled-content>25. These parameters overlap with the diagnostic criteria for <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>. Such confounding factors make the management of post\u2010<jats:styled-content style=\"fixed-case\">HSCT HLH<\/jats:styled-content> quite challenging. We illustrate this critical issue with case report of a patient who was diagnosed with <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> after allogeneic <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">tAML<\/jats:styled-content>. He received <jats:styled-content style=\"fixed-case\">MP<\/jats:styled-content> and CsA for <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> but <jats:styled-content style=\"fixed-case\">VP<\/jats:styled-content>\u201016 was not administered due to fear of severe myelosuppression. Fortunately, he responded well to treatment and remains in remission to date. We recommend caution while using <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>\u201094\/<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>\u20102004 guidelines for the diagnosis and management of post\u2010<jats:styled-content style=\"fixed-case\">HSCT HLH<\/jats:styled-content>. In this article, we pinpoint these issues with a brief review of all the pediatric cases and clinical studies of post\u2010<jats:styled-content style=\"fixed-case\">HSCT HLH<\/jats:styled-content> along with a critical evaluation of its various diagnostic criteria. Finally, based on the limitations of current diagnostic criteria, we suggest a need for formulating disease\u2010specific diagnostic criteria for post\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> HLH.<\/jats:p>","DOI":"10.1111\/petr.13174","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T04:19:58Z","timestamp":1522037998000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Post\u2010hematopoietic stem cell transplant hemophagocytic lymphohistiocytosis or an impostor: Case report and review of literature"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2993-0490","authenticated-orcid":false,"given":"Anant","family":"Vatsayan","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology UH Rainbow Babies and Children's Hospital  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Pateva","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology UH Rainbow Babies and Children's Hospital  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Cabral","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology UH Rainbow Babies and Children's Hospital  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jignesh","family":"Dalal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology UH Rainbow Babies and Children's Hospital  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolla","family":"Abu\u2010Arja","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology Oncology and Bone Marrow Transplant Nationwide Children's Hospital  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,25]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14147"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1532\/IJH97.07012"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0925-5710(97)00584-7"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0925-5710(96)00560-9"},{"key":"e_1_2_5_6_1","first-page":"99","article-title":"Bone marrow transplantation from an unrelated donor for Fanconi's anaemia: two unusual complications","volume":"2","author":"Sokal E","year":"1987","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_5_7_1","first-page":"349","article-title":"Adenovirus\u2010related hemophagocytic syndrome after bone marrow transplantation","volume":"6","author":"Levy J","year":"1990","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199123000-00010"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1532\/IJH97.04063"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705517"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705783"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02984009"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.11704"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-2896.2005.00220.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2009.01217.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12567"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-015-1905-y"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-009-0261-1"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23384"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07863.x"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2013.145"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2012.01757.x"},{"key":"e_1_2_5_23_1","first-page":"29","article-title":"Diagnostic guidelines for hemophagocytic lymphohistiocytosis. 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