Successful salvage treatment with antithymocyte globulin for patients with early-onset hemophagocytic lymphohistiocytosis refractory to steroid and etoposide therapy following allogeneic hematopoietic stem cell transplantation

Kakinoki, Yasutaka; Ishio, Takashi; Kimura, Hiroyuki; Shimono, Joji; Miyashita, Naoki; Sekine, Takahiro; Kasahara, Keiji

doi:10.1038/s41409-020-0802-z

Cited by 3 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HLH cases require aggressive immunosuppression involving corticosteroids and anti-IL-6 therapy (tocilizumab or siltuximab) with supportive care [ 57 ]. If immunosuppression fails to reduce toxicity, etoposide should be considered [ 57 , 58 ]. For HLH management, intravenous immunoglobulin has also been recommended [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Safety of CAR-T Cell Therapy in Patients With Renal Failure/Acute Kidney Injury: Focused Review

Khan¹,

Khan

Wolfson

et al. 2023

Clin Hematol Int

View full text Add to dashboard Cite

Chimeric antigen receptor (CAR) T-cell therapy is novel immunotherapy targeting specifically cancerous cells, and has been shown to induce durable remissions in some refractory hematological malignancies. However, CAR T-cell therapy has adverse effects, such as cytokine release syndrome (CRS), immune effector-associated neurotoxicity syndrome (ICANS), tumor lysis syndrome (TLS), and acute kidney injury (AKI), among others. Not many studies have covered the repercussions of CAR T-cell therapy on the kidneys. In this review, we summarized the available evidence on the safety profile of CAR T-cell therapy in patients with pre-existing renal insufficiency/AKI and in those who develop AKI as a result of CAR T-cell therapy. With a 30% incidence of AKI post-CAR T-cell, various pathophysiological mechanisms, such as CRS, hemophagocytic lymphohistiocytosis (HLH), TLS, serum cytokines, and inflammatory biomarkers, have been shown to play a role. However, CRS is commonly reported as an underlying mechanism. Overall, 18% of patients in our included studies developed AKI after receiving CAR T-cell therapy, and most cases were reversible with appropriate therapy. While phase-1 clinical trials exclude patients with significant renal toxicity, two studies (Mamlouk et al. and Hunter et al.) reported successful treatment of dialysis-dependent patients with refractory diffuse large B-cell lymphoma, and demonstrated that CAR T-cell therapy and lymphodepletion (Flu/Cy) can be safely administered.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety of CAR-T Cell Therapy in Patients With Renal Failure/Acute Kidney Injury: Focused Review

Khan¹,

Khan

Wolfson

et al. 2023

Clin Hematol Int

View full text Add to dashboard Cite

show abstract

“…In the literature, it has been reported that remission was achieved in 73% of pediatric HLH patients treated with ATG. 40 , 41 In other words, the ATG option should be kept in mind to achieve remission in resistant patients who were previously treated according to the HLH-2004 protocol.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Genetic, and Outcome Characteristics of Pediatric Patients with Primary Hemophagocytic Lymphohistiocytosis

Nepesov¹,

Yaman²,

Elli³

et al. 2022

Turk Arch Pediatrics

View full text Add to dashboard Cite

Objectİive: In this study, we sought to describe the clinical, laboratory, and genetic characteristics of patients diagnosed with primary hemophagocytic lymphohistiocytosis. Thus, we aimed to evaluate the early diagnosis and appropriate treatment options for pediatric hemophagocytic lymphohistiocytosis patients. Materials and Methods: Medical records of 9 patients diagnosed with primary hemophagocytic lymphohistiocytosis between November 2013 and December 2019 were analyzed retrospectively. Clinical, genetic, and laboratory characteristics, family histories, initial complaints, physical examination findings, age at diagnosis, treatment choices, and clinical follow-up of all patients were investigated. Results: The mean age at diagnosis was 11 months (range: 1.5 months to 17 years). Genetic analysis was performed in all patients, and a disease-related mutation was detected in 8 (89%) of them. Among clinical features, 6 (66%) patients had fever, 5 (56%) had splenomegaly, 4 (44%) had lymphadenopathy, 4 (44%) had skin rash, and 4 (44%) had neurological findings. Hemophagocytosis was observed in the bone marrow samples of 6 (66%) patients. Disease remission was achieved in 7 (78%) patients. Hematopoietic stem cell transplantation was performed in 7 (78%) patients. Conclusion: Hemophagocytic lymphohistiocytosis may present with different clinical symptoms that can cause a significant diagnostic delay. The only curative treatment option in primary hemophagocytic lymphohistiocytosis patients is hematopoietic stem cell transplantation. The chemotherapy should be started as early as possible, in order to achieve a disease remission. Patients should be referred to the appropriate bone marrow transplant center for hematopoietic stem cell transplantation as soon as they reach the disease remission.

show abstract

Chimeric antigen receptor T cell therapy and nephrotoxicity: From diagnosis to treatment strategies

Zhou

Cui

Jiang

2020

International Immunopharmacology

View full text Add to dashboard Cite

Successful salvage treatment with antithymocyte globulin for patients with early-onset hemophagocytic lymphohistiocytosis refractory to steroid and etoposide therapy following allogeneic hematopoietic stem cell transplantation

Cited by 3 publications

References 15 publications

Safety of CAR-T Cell Therapy in Patients With Renal Failure/Acute Kidney Injury: Focused Review

Safety of CAR-T Cell Therapy in Patients With Renal Failure/Acute Kidney Injury: Focused Review

Clinical, Genetic, and Outcome Characteristics of Pediatric Patients with Primary Hemophagocytic Lymphohistiocytosis

Chimeric antigen receptor T cell therapy and nephrotoxicity: From diagnosis to treatment strategies

Contact Info

Product

Resources

About