Login / Signup

Hyperinflammatory syndrome resembling haemophagocytic lymphohistiocytosis following axicabtagene ciloleucel and brexucabtagene autoleucel.

Timothy J PorterAna LazarevicJamie E ZiggasEphraim FuchsKiryoung KimHelen ByrnesLeo LuznikJavier Bolaños-MeadeSyed Abbas AliNirali N ShahNina D Wagner-JohnstonTania Jain
Published in: British journal of haematology (2022)
Haemophagocytic lymphohistiocytosis-like toxicity following chimeric antigen receptor T cells (CAR-HLH) is being increasingly recognized, while published data are limited and criteria for recognition are elusive. We describe three patients who developed CAR-HLH after infusion of brexucabtagene autoleucel (n = 2) or axicabtagene ciloleucel (n = 1). All three patients presented following cytokine release syndrome, with fever, recurrent or worsening cytopenias, hyperferritinaemia, elevated soluble interleukin (IL)-2 receptor, hypofibrinogenaemia, hypertriglyceridaemia, elevated liver transaminases, and decreasing C-reactive protein and IL-6. Clinical improvement following treatment with anakinra (n = 2) and ruxolitinib (n = 1) was observed. Our report offers an opportunity for prompt recognition and initiation of potentially life-saving treatment for CAR-HLH.
Keyphrases
  • case report
  • oxidative stress
  • systematic review
  • chronic kidney disease
  • patient reported outcomes
  • artificial intelligence
  • smoking cessation
  • meta analyses
  • oxide nanoparticles