ReviewMedicine2026
A case report of hemophagocytic lymphohistiocytosis occurring during ibrutinib chemotherapy with a literature review.
Review in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
rationaleIbrutinib, a Bruton tyrosine kinase inhibitor, is widely used in chronic lymphocytic leukemia (CLL). Its association with secondary hemophagocytic lymphohistiocytosis (HLH) is exceedingly rare but potentially fatal. PATIENT CONCERNS: A 59-year-old male with CLL presented with recurrent fever and progressive splenomegaly. DIAGNOSES: Bone marrow biopsy confirmed CLL. Five months after ibrutinib (420 mg/day) initiation, progressive pancytopenia, hyperferritinemia, and hemophagocytosis on repeat marrow aspirate established HLH diagnosis.
interventionsHLH-94 protocol (etoposide + dexamethasone) was initiated. OUTCOMES: The patient developed fungemia followed by massive cerebral infarction. Treatment was withdrawn due to deterioration, resulting in death. LESSONS: Ibrutinib may trigger HLH via immune dysregulation. Early recognition through vigilant monitoring of cytopenias, ferritin, and marrow hemophagocytosis is critical to improve survival.
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