ArticleJournal of clinical medicine2023
Hemophagocytic Lymphohistiocytosis Associated with Immunological Checkpoint Inhibitors: A Pharmacovigilance Study.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hemophagocytic lymphohistiocytosis following pembrolizumab and bevacizumab combination therapy for cervical cancer: a case report and systematic review.BMC geriatrics · 2024Pooled it
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- Article
- Article
- A Narrative Review of Drug-Induced Haemophagocytic Lymphohistiocytosis: A Rare but Relevant Differential Diagnosis.International archives of allergy and immunology · 2026Review
- Tocilizumab for steroid-refractory hemophagocytic syndrome after durvalumab and tremelimumab for advanced hepatocellular carcinoma.Clinical journal of gastroenterology · 2026Article
- Successful rechallenge of BRAF/MEK inhibitor with ruxolitinib in BRAF/MEK inhibitor-induced hemophagocytic lymphohistiocytosis like hyperinflammatory syndrome inFrontiers in oncology · 2026Article
- Immune Checkpoint Inhibitor-Associated Hemophagocytic Lymphohistiocytosis: A Systematic Review.Clinical Medicine Insights. Oncology · 2026Review
- Secondary hemophagocytic lymphohistiocytosis associated with adjuvant pembrolizumab therapy in a young patient with triple-negative breast cancer: a case report with literature review.Archives of gynecology and obstetrics · 2025Review
- Article
- Trimethoprim/sulfamethoxazole and risk of haemophagocytic lymphohistiocytosis (HLH): a literature review and disproportionality analysis using individual case safety reports from FAERS.The Journal of antimicrobial chemotherapy · 2025Review
- A Case of Hemophagocytic Lymphohistiocytosis During Immune Checkpoint Inhibitor Treatment for Metastatic Renal Cell Carcinoma, Complicated by Pancytopenia Attributed to Cytomegalovirus Infection.IJU case reports · 2025Article
- Hemophagocytic lymphohistiocytosis induced by immune checkpoint inhibitors: observations and proposed clinical management.Frontiers in immunology · 2025Review
- Tislelizumab-induced hemophagocytic lymphohistiocytosis in a patient with microsatellite instability-high colon cancer and coexisting systemic lupus erythematosus: a case report and literature review.Frontiers in oncology · 2025Article
- Interdependence of coagulation with immunotherapy and BRAF/MEK inhibitor therapy: results from a prospective study.Cancer immunology, immunotherapy : CII · 2024Article
- A case report of hemophagocytic lymphohistiocytosis induced by toripalimab plus chemoradiotherapy in cervical cancer.Heliyon · 2024Article
- Immune-Related Adverse Events Due to Cancer Immunotherapy: Immune Mechanisms and Clinical Manifestations.Cancers · 2024Review
- Rare Immune-Related Adverse Events (irAEs): Approach to Diagnosis and Management.Pharmaceutical medicine · 2024Review
- Fever of unknown origin associated with immune checkpoint inhibitors.Frontiers in immunology · 2024Review
- Checkpoint inhibitors.Hematology. American Society of Hematology. Education Program · 2023Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcquired hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal condition characterized by hyperactivation of macrophages and cytotoxic lymphocytes, combining a series of non-specific clinical symptoms and laboratory disorders. Etiologies are multiple: infectious (mainly viral) but also oncologic, autoimmune or drug-induced. Immune checkpoint inhibitors (ICI) are recent anti-tumor agents associated with a novel profile of adverse events triggered by immune system over-activation. Here, we sought to provide a comprehensive description and analysis of HLH cases reported with ICI since 2014.
methodsDisproportionality analyses were performed in order to further explore the association between ICI therapy and HLH. We selected 190 cases, 177 from the World Health Organization pharmacovigilance database and 13 from the literature. Detailed clinical characteristics were retrieved from the literature and from the French pharmacovigilance database.
resultsThe cases of HLH reported with ICI concerned men in 65% of cases with a median age of 64 years. HLH occurred in an average of 102 days after the initiation of ICI treatment and mostly concerned nivolumab, pembrolizumab and nivolumab/ipilimumab combination. All cases were considered serious. Most cases presented a favorable outcome (58.4%); however, death was reported for 15.3% of patients. Disproportionality analyses showed that HLH was seven times more frequently reported with ICI therapy than with other drugs and three times more than with other antineoplastic agents.
conclusionsClinicians should be aware of the potential risk of ICI-related HLH to improve the early diagnosis of this rare immune-related adverse event.
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