Inflammatory Malignant Fibrous Histiocytoma Associated with Leukemoid Reaction or Leukocytosis: A Comprehensive Review

Abstract

Inflammatory malignant fibrous histiocytoma (IMFH) associated with leukemoid reaction (LR)/leukocytosis is a rare entity. In this paper, we search PubMed for all known cases of IMFH associated with LR/leukocytosis in an attempt to draw conclusions about this variant's response to treatments and its pathophysiology. Medline electronic database was searched using key words such as malignant fibrous histiocytoma, leukemoid reaction, and leukocytosis. A total of 16 patients were found, twelve males (75%) and 4 female (25%), with a mean age of 62.6 years, ranging from 47 to 77. The mean survival was 770 days, ranging from 14 to 6570 days. Four patients were alive at last follow-up: 6570 days, 1095 days, 335 days, and 180 days, respectively. Of the 12 patients that expired, death occurred approximately 92 days after the onset of LR or leukocytosis, ranging from 3 to 334 days. We conclude that IMFH associated with LR/leukocytosis does not completely respond to chemoradiation. Overproduction of growth factors and cytokines by IMFH cells and their interactions with the inflammatory infiltrate seem to promote immunological effector cell's dysfunction and substantiate the development and growth of this neoplasm. A clear understanding of these molecular pathways is crucial in order to identify targets for potential therapy.

Inflammatory Undifferentiated Pleomorphic Sarcoma Mimicking Bacteremia in an Elderly Patient: A Case Report

“…The current case could be further classified as immune-high (D and E), and/or highly vascularized (C) groups. Rapid growth and early metastasis have been observed in IUPS, and the involvement of G-CSF, IL-6, IL-7, IL-8, SCF, TGB, and G-CSF have also been suggested [ 4 , 14 , 15 ]. IL-6 is an important cytokine that plays various roles in many cells, such as proliferation of T lymphocytes, induction of B lymphocyte maturation, promotion of the growth of erythroid cells, myeloid cells, and megakaryocytes, and the induction of acute phase protein production by hepatocytes [ 16 , 17 , 18 ].…”

A Massive Retroperitoneal Mass With Leukocytosis

“…Many still favor its use, especially in cases with the highest risk of recurrence, given the potential of radiotherapy to decrease local recurrence . Following surgical resection, a recurrent leukocytosis frequently marks disease recurrence . The leukocytosis associated with these masses led some to initially believe that they were of lymphomatous origin, but they are now considered a subtype of dedifferentiated liposarcoma based on immunohistochemical and genomic analysis …”

Leukemoid reaction in cervical cancer: a case report and review of the literature

“…Despite stimulating bone marrow to sustain leukocytosis, IL-3, GM-CSF, and G-CSF have been shown to stimulate the growth of clonogenic cells of some nonhematopoietic malignant cell lines in vitro [ 5 ]. Hurtado et al found that when G-CSF was overproduced by tumor cells, it had a tendency to encourage the development of myeloid-derived suppressor cells (MDSC), which could travel to lymph nodes to prevent dendritic cell-primed T lymphocytes from eliminating tumor cells [ 10 ]. Therefore, consistent with the clinical presentation of our case, paraneoplastic granulocytosis is often associated with rapid tumor growth and poor clinical prognosis, although it resolves with the treatment of the underlying cancers.…”

“…In a comprehensive review of inflammatory malignant fibrous histiocytoma (IMFH) associated with LR or leukocytosis, the severity of LR was correlated with the time of death. Once the WBC reached 100*10 9 /L, the patients were not capable of tolerating any chemoradiation secondary to their unstable clinical condition [ 10 ]. Mabuchi also concluded that pretreatment leukocytosis was an independent prognostic factor in patients with cervical cancer [ 18 ].…”