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Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature

BACKGROUND: Immune checkpoint inhibitors avoid inhibition of T-cell responses, upregulating antitumor immune response. Moreover, a dysregulation with hyperactive immune response can be caused, some of them underdiagnosed. Hemophagocytic lymphohistiocytosis is a rare and often fatal syndrome of uncon...

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Autores principales: Rubio-Perez, Jaime, Rodríguez-Perez, Ángel Ricardo, Díaz-Blázquez, María, Moreno-García, Victor, Dómine-Gómez, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531226/
https://www.ncbi.nlm.nih.gov/pubmed/36195892
http://dx.doi.org/10.1186/s13256-022-03585-3
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author Rubio-Perez, Jaime
Rodríguez-Perez, Ángel Ricardo
Díaz-Blázquez, María
Moreno-García, Victor
Dómine-Gómez, Manuel
author_facet Rubio-Perez, Jaime
Rodríguez-Perez, Ángel Ricardo
Díaz-Blázquez, María
Moreno-García, Victor
Dómine-Gómez, Manuel
author_sort Rubio-Perez, Jaime
collection PubMed
description BACKGROUND: Immune checkpoint inhibitors avoid inhibition of T-cell responses, upregulating antitumor immune response. Moreover, a dysregulation with hyperactive immune response can be caused, some of them underdiagnosed. Hemophagocytic lymphohistiocytosis is a rare and often fatal syndrome of uncontrolled and ineffective hyperinflammatory response that triggers an inflammatory cascade that can lead in many cases to death. CASE PRESENTATION: We report the case of a 67-year-old Caucasian man with stage IV lung adenocarcinoma who developed hemophagocytic lymphohistiocytosis after initiation of atezolizumab, an antagonist of programmed death-ligand 1. Even with early diagnosis and proper treatment, death occurs in approximately half of all cases reported. CONCLUSION: Key markers are needed to better identify patients at risk of developing severe immune-related adverse events. In addition to key markers, a higher degree of suspicion and early intervention are needed to improve outcomes in acquired hemophagocytic lymphohistiocytosis, especially with the increasingly and expanding use of immune activation.
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spelling pubmed-95312262022-10-04 Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature Rubio-Perez, Jaime Rodríguez-Perez, Ángel Ricardo Díaz-Blázquez, María Moreno-García, Victor Dómine-Gómez, Manuel J Med Case Rep Case Report BACKGROUND: Immune checkpoint inhibitors avoid inhibition of T-cell responses, upregulating antitumor immune response. Moreover, a dysregulation with hyperactive immune response can be caused, some of them underdiagnosed. Hemophagocytic lymphohistiocytosis is a rare and often fatal syndrome of uncontrolled and ineffective hyperinflammatory response that triggers an inflammatory cascade that can lead in many cases to death. CASE PRESENTATION: We report the case of a 67-year-old Caucasian man with stage IV lung adenocarcinoma who developed hemophagocytic lymphohistiocytosis after initiation of atezolizumab, an antagonist of programmed death-ligand 1. Even with early diagnosis and proper treatment, death occurs in approximately half of all cases reported. CONCLUSION: Key markers are needed to better identify patients at risk of developing severe immune-related adverse events. In addition to key markers, a higher degree of suspicion and early intervention are needed to improve outcomes in acquired hemophagocytic lymphohistiocytosis, especially with the increasingly and expanding use of immune activation. BioMed Central 2022-10-04 /pmc/articles/PMC9531226/ /pubmed/36195892 http://dx.doi.org/10.1186/s13256-022-03585-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Rubio-Perez, Jaime
Rodríguez-Perez, Ángel Ricardo
Díaz-Blázquez, María
Moreno-García, Victor
Dómine-Gómez, Manuel
Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
title Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
title_full Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
title_fullStr Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
title_full_unstemmed Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
title_short Treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
title_sort treatment-related hemophagocytic lymphohistiocytosis due to atezolizumab: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531226/
https://www.ncbi.nlm.nih.gov/pubmed/36195892
http://dx.doi.org/10.1186/s13256-022-03585-3
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