Analysis of one case of hemophagocytic lymphohistiocytosis following CAR-T cell therapy for Hodgkin's lymphoma
LIU Guixi
LIU Yuyu
LI Banban
BAI Guanchen
Abstract：Objective To analyze the clinical data of a patient with hemophagocytic lymphohistiocytosis(HLH)fol-lowing treatment with chimeric antigen receptor T(CAR-T)cells for Hodgkin's lymphoma,and to summarize the early identification and effective management of this condition.Methods We conducted a retrospective analysis of the clinical data from one patient diagnosed with Hodgkin's lymphoma who developed HLH after CAR-T cell therapy.Results A 22-year-old woman,initially diagnosed with Hodgkin's lymphoma,experienced recurrence after standard chemotherapy com-bined with allogeneic hematopoietic stem cell transplantation.She subsequently relapsed again following anti-CD30 CAR-T cell therapy.After receiving humanized anti-CD30/NKG2D CAR-T cell therapy,the patient presented symptoms includ-ing chest tightness,dyspnea,liver function impairment,elevated lactate dehydrogenase and ferritin levels,hyperdirect bilirubinemia,and hypofibrinogenemia.Based on her clinical symptoms and laboratory findings,she was diagnosed with CAR-T cell therapy-related HLH,namely immune effector cell-associated hemophagocytic lymphohistiocytosis syndrome(IEC-HS).Following treatment with glucocorticoids,ruxolitinib,and etoposide,both HLH-related symptoms and associ-ated laboratory indicators improved.A chest CT scan performed at 50 days after CAR-T cell transfusion revealed inflamma-tion in the upper lobe of the left lung,and a fungal infection was suspected.Unfortunately,the patient died of pulmonary hemorrhage on day 52.Conclusions IEC-HS represents a serious complication arising from CAR-T cell therapy for Hodgkin's lymphoma.The rapid and sustained increase in ferritin levels alongside target organ damage and hemophagocy-tosis following CAR-T treatment can facilitate early identification of IEC-HS.After the diagnosis is confirmed,administra-tion of glucocorticoids along with ruxolitinib and etoposide helps to relieve the symptoms.
Keywords：hemophagocytic lymphohistiocytosisCAR-T cellscytokine release syndromeHodgkin's lymphoma
Publication Date：2025-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 85-89 )