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依托泊苷磷酸酯输注治疗复发急性淋巴细胞白血病后噬血细胞性淋巴组织细胞增多症/巨噬细胞活化综合征一例:病例报告。

Dramatic Recovery after Etoposide Phosphate Infusion for Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome following Treatment with Tisagenlecleucel in a Young Patient with Relapsed Acute Lymphoblastic Leukemia: A Case Report.

机构信息

Hematology Department, Nantes University Hospital, Nantes, France.

Medical Intensive Care Unit, Nantes University Hospital, Nantes, France.

出版信息

Acta Haematol. 2022;145(5):537-541. doi: 10.1159/000525576. Epub 2022 Jun 20.


DOI:10.1159/000525576
PMID:35724631
Abstract

The occurrence of a secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS) after CAR T-cell infusion is very rare and mostly fatal. Treatment recommendations for such a complication are not yet established. Here, we report the dramatic recovery of HLH/MAS following tisagenlecleucel infusion in a young patient with relapsed acute lymphoblastic leukemia using etoposide phosphate (EP). We propose that monitoring for the occurrence of HLH/MAS should be part of surveillance after CAR T-cell infusion and that EP treatment appears to be useful to control this severe and rare complication.

摘要

嵌合抗原受体 T 细胞输注后发生二级噬血细胞性淋巴组织细胞增生症/巨噬细胞活化综合征(HLH/MAS)非常罕见,且大多致命。对于此类并发症,尚无确立的治疗建议。在此,我们报告了一例复发性急性淋巴细胞白血病患儿在接受嵌合抗原受体 T 细胞输注后使用磷酸依托泊苷(EP)治疗噬血细胞性淋巴组织细胞增生症/巨噬细胞活化综合征(HLH/MAS)的戏剧性恢复。我们建议,在嵌合抗原受体 T 细胞输注后,应监测 HLH/MAS 的发生,且 EP 治疗似乎可有效控制这种严重且罕见的并发症。

相似文献

[1]
Dramatic Recovery after Etoposide Phosphate Infusion for Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome following Treatment with Tisagenlecleucel in a Young Patient with Relapsed Acute Lymphoblastic Leukemia: A Case Report.

Acta Haematol. 2022

[2]
Efficacy of Moderately Dosed Etoposide in Macrophage Activation Syndrome-Hemophagocytic Lymphohistiocytosis.

J Rheumatol. 2021-10

[3]
Hemophagocytic lymphohistiocytosis and macrophage activation syndrome: two rare sides of the same devastating coin.

Adv Rheumatol. 2024-4-16

[4]
Diagnosis and Management of Secondary HLH/MAS Following HSCT and CAR-T Cell Therapy in Adults; A Review of the Literature and a Survey of Practice Within EBMT Centres on Behalf of the Autoimmune Diseases Working Party (ADWP) and Transplant Complications Working Party (TCWP).

Front Immunol. 2020-3-31

[5]
Experience with hemophagocytic lymphohistiocytosis/macrophage activation syndrome at a single institution.

J Pediatr Hematol Oncol. 2009-2

[6]
Hemophagocytic lymphohistiocytosis: a review inspired by the COVID-19 pandemic.

Rheumatol Int. 2021-1

[7]
Precursor B-cell acute lymphoblastic leukemia presenting with hemophagocytic lymphohistiocytosis.

Pediatr Blood Cancer. 2008-2

[8]
Unmasking of systemic lupus erythematosus in a patient with hemophagocytic lymphohistiocytosis- macrophage activation syndrome (HLA-MAS) and diffuse alveolar hemorrhage.

Reumatismo. 2023-3-21

[9]
Intravenous anakinra for the treatment of haemophagocytic lymphohistiocytosis/macrophage activation syndrome: A systematic review.

Eur J Haematol. 2023-9

[10]
[Report of a case with secondary acute promyelocytic leukemia after therapy for hemophagocytic lymphohistiocytosis and review of literature].

Zhonghua Er Ke Za Zhi. 2013-12

引用本文的文献

[1]
Less frequent complications following CAR T-cell therapies: hemophagocytic lymphohistiocytosis, graft-versus-host disease, thrombotic microangiopathy, coagulation disorders and secondary malignancies: best practice recommendations from the EBMT Practice Harmonization and Guidelines Committee.

Bone Marrow Transplant. 2025-4-9

[2]
Hemophagocytic lymphohistiocytosis in a patient with Epstein-Barr virus-positive diffuse large B-cell lymphoma treated with chimeric antigen receptor T-cell therapy.

Immunotherapy. 2024

[3]
Etoposide Therapy of Cytokine Storm Syndromes.

Adv Exp Med Biol. 2024

[4]
Treatment strategies for progressive immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome: case series.

Haematologica. 2024-10-1

[5]
Risk factors and outcome of Chimeric Antigen Receptor T-Cell patients admitted to Pediatric Intensive Care Unit: CART-PICU study.

Front Immunol. 2023

[6]
Immune Effector Cell-Associated Hemophagocytic Lymphohistiocytosis-Like Syndrome.

Transplant Cell Ther. 2023-7

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