Daratumumab-associated hemophagocytic lymphohistiocytosis

Woods, Ashley; Wooten, Melanie; Heffner, Leonard T.; Waller, Edmund

doi:10.1007/s00277-019-03877-7

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…One of the postulated HLH triggers is the inability of NK cells to induce lysis of activated T cells and histiocytes. Both lenalidomide and daratumumab treatment disrupt immune homeostasis by altering and dysregulating NK cells’ function, and therefore may contribute to the onset of the disease [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Secondary Hemophagocytic Syndrome in a Patient with Plasma Cell Myeloma and CNS Involvement Treated with Lenalidomide

et al. 2022

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We present an extremely rare case report of a 29-year-old multiple myeloma patient with central nervous system involvement and secondary hemophagocytic lymphohistiocytosis (HLH). We observed that HLH was presumably triggered by the immunomodulatory drug—lenalidomide. HLH is frequently misdiagnosed or underdiagnosed. As HLH requires immediate treatment, our report emphasizes the need to consider HLH in the differential diagnosis when the condition of a patient receiving chemotherapy rapidly deteriorates and an infectious etiology is excluded. We furthermore discuss the pathogenesis of HLH, with particular emphasis on drugs affecting the immune system as well as possible therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Secondary Hemophagocytic Syndrome in a Patient with Plasma Cell Myeloma and CNS Involvement Treated with Lenalidomide

et al. 2022

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“…She received daratumumab after the failure of first-line and second-line therapy and showed clinical improvement. Although only two single cases were reported, it still suggested that daratumumab has potential therapeutic value for AE, but its value should be carefully examined due to its serious adverse events ( 69 ).…”

Section: Daratumumabmentioning

confidence: 99%

Immunotherapy for Refractory Autoimmune Encephalitis

Yang

Liu

2021

Front. Immunol.

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Autoimmune encephalitis (AE) is an immune-mediated disease involving the central nervous system, usually caused by antigen-antibody reactions. With the advent of autoantibody-associated diseases, AE has become a hot research frontier in neuroimmunology. The first-line conventional treatments of autoimmune encephalitis consist of steroids, intravenous immunoglobulin (IVIG), plasma exchange (PLEX), and second-line therapy includes rituximab. Despite considerable research and expanding clinical experience, current treatments are still ineffective for a significant number of patients. Although there is no clear consensus, clinical trial evidence limited, and the level of evidence for some of the drugs based on single reports, third-line therapy is a viable alternative for refractory encephalitis patients. With the current rapid research progress, a breakthrough in the treatment of AE is critical. This article aims to review the third-line therapy for refractory AE

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“…Interestingly, HLH secondary to disseminated histoplasmosis in systemic lupus erythematosus [3] or in patients with human immunodeficiency virus (HIV) [4,5] has been described. Moreover, from the newest immunomodulatory monoclonal antibodies, the drug daratumumab has been implicated for inducing HLH as well [6].…”

Section: Introductionmentioning

confidence: 99%

Hemophagocytic Lymphohistiocytosis as a Manifestation of Underlying Visceral Leishmaniasis

Diamantidis

Palioura

Ιωάννου

et al. 2020

Cureus

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Hemophagocytic lymphohistiocytosis (HLH), or hemophagocytic syndrome (HS) is a severe syndrome involving an extreme participation of the immune system, resulting in a cascade of cytokines, hyperinflammation and extensive hemophagocytosis in the bone marrow (BM) and affecting the peripheral blood (PB) lineages. Fever, splenomegaly, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia are often encountered in this disease. The syndrome can be seen in all ages and it is either primary due to genetic defects or secondary because of malignancies, immune deficiencies, rheumatic diseases, and infections. Bacteria, viruses, protozoa, and fungi are often implicated. Visceral leishmaniasis (VL) is among the infectious causes of HLH. We describe a patient with a successful treatment of HLH after the initiation of liposomal amphotericin B, due to VL, even though there was a delay in diagnosing the leishmaniasis. The exact precipitating pathophysiological events triggering HLH remain unknown and provide their clear impact for future research. An instructive, critical review of the literature related to the presented case is provided. Distinguishing secondary HS from primary HS is essential for the application of suitable treatment. Improper use of corticosteroids could cover up an underlying possible malignancy or infection and delay the initiation of the etiologic therapeutic strategy.

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Daratumumab-associated hemophagocytic lymphohistiocytosis

Cited by 6 publications

References 5 publications

Secondary Hemophagocytic Syndrome in a Patient with Plasma Cell Myeloma and CNS Involvement Treated with Lenalidomide

Secondary Hemophagocytic Syndrome in a Patient with Plasma Cell Myeloma and CNS Involvement Treated with Lenalidomide

Immunotherapy for Refractory Autoimmune Encephalitis

Hemophagocytic Lymphohistiocytosis as a Manifestation of Underlying Visceral Leishmaniasis

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