Hemophagocytic syndrome after autologous peripheral blood stem cell transplantation for multiple myeloma; successful treatment with high-dose intravenous immunoglobulin

Ostronoff, M; Ostronoff, Fabiana; Coutinho, Mariana; Calixto, Rodolfo; Maior, Ana Patricia Souto; Sucupira, Alexandre; Florêncio, Rodrigo; Tagliari, C.

doi:10.1038/sj.bmt.1705329

Cited by 17 publications

(19 citation statements)

References 9 publications

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“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The frequency of HLH after SCT was reported as 4.1% in patients who had undergone autologous and allogeneic SCT 6 and was reported as 16.8% in patients who underwent CBT. 7 In the present study, the cumulative incidence of HLH was 4.3% in all patients and was 5.8% in patients who underwent CBT.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of HLH after SCT have not included many patients who received an etoposide-containing condition regimen. 8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Indeed, none of the patients in the report by Takagi et al received an etoposide-containing condition regimen. 6 These facts may also serve to support our speculation.…”

Section: Discussionmentioning

confidence: 99%

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Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

Kobayashi

Tanaka

Hashino

et al. 2013

Bone Marrow Transplant

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Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease of severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages that secrete high amounts of inflammatory cytokines. HLH occurring after SCT is difficult to diagnose. It is characterized by severe clinical manifestations and high mortality. Despite current therapeutic approaches, outcomes remain poor. We analyzed the incidence and risk factors of HLH after SCT and the response to treatment and prognosis of 554 patients with HLH after SCT. The cumulative incidence of HLH after SCT was 4.3% (24/554). Use of etoposide in the conditioning regimen was only factor that reduced HLH after SCT (P ¼ 0.027). All patients who received autologous transplantation were successfully treated. Patients with liver dysfunction (for example, high total bilirubin level, prolonged prothrombin time and high level of fibrinogen degradation products) had a poor response to treatment for HLH. Physicians should be cautious of HLH, while not using etoposide for conditioning regimen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

Kobayashi

Tanaka

Hashino

et al. 2013

Bone Marrow Transplant

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“…HLH has previously rarely been reported to be associated with MM, and we were able to find only four such cases in the literature [14][15][16][17].…”

Section: Myeloma-associated Hlhmentioning

confidence: 58%

“…So far, five cases (including this report) of myeloma-associated HLH were published in the literature [14][15][16][17]. Nevertheless, all of these MM cases differ at many points, e.g.…”

Section: Discussionmentioning

confidence: 94%

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Acquired hemophagocytic lymphohistiocytosis associated with multiple myeloma

et al. 2010

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Acquired or secondary hemophagocytic lymphohistiocytosis (sHLH) is a life-threatening hyperinflammation syndrome caused mostly by various infectious agents, autoimmune disorders or malignancy. So far, only anecdotal cases of sHLH associated with multiple myeloma have been published. We provide a review of all these reports and include a previously not published case of myeloma-associated sHLH in a 59-year-old male with complex partial epilepsy. Due to aggressive course of sHLH, increased awareness is indicated in all patients with malignancies which develop unremitting fever, cytopenia and splenomegaly. Early diagnosis and immediate introduction of adequate therapy is crucial for the outcome of HLH.

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Myeloma‐associated hemophagocytic lymphohistiocytosis – A comprehensive case study and a novel chemotherapy‐free approach with anakinra

Al‐Ammari,

Hsu,

Bryant

2024

eJHaem

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Hemophagocytic lymphohistiocytosis (HLH) is an immune response syndrome characterized by excessive inflammation and tissue destruction. A limited number of cases involving HLH patients with concomitant multiple myeloma (MM), leading to significant mortality, have been documented, underscoring the importance of timely diagnosis. We present the case of a 78‐year‐old previously healthy male admitted to our hospital with a newly diagnosed MM. Subsequently, he was diagnosed with HLH and received treatment with anakinra, intravenous immunoglobulin, and dexamethasone. This case report highlights the unique aspect of being the first documented instance of myeloma‐associated HLH treated with anakinra.

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Hemophagocytic syndrome after autologous peripheral blood stem cell transplantation for multiple myeloma; successful treatment with high-dose intravenous immunoglobulin

Cited by 17 publications

References 9 publications

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT

Acquired hemophagocytic lymphohistiocytosis associated with multiple myeloma

Myeloma‐associated hemophagocytic lymphohistiocytosis – A comprehensive case study and a novel chemotherapy‐free approach with anakinra

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