ArticleASM case reports2026
Toxoplasmosis-associated hemophagocytic lymphohistiocytosis during tumor-infiltrating lymphocyte therapy.
Article in ASM case reports, 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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Abstract
Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome triggered by infections, malignancies, or autoimmune disorders. Tumor-infiltrating lymphocyte (TIL) therapy requires lymphodepleting chemotherapy and interleukin-2, producing profound immunosuppression. While HLH-like syndromes have been characterized after chimeric antigen receptor T-cell therapy, HLH has not been reported in the setting of TIL therapy. Case Summary: A 68-year-old male with metastatic melanoma undergoing TIL therapy presented with altered mental status. He had chronic lymphopenia and reported gastrointestinal intolerance to trimethoprim-sulfamethoxazole, documented as a sulfonamide allergy without formal testing, limiting prophylaxis to inhaled pentamidine, which has no anti- Conclusion: This represents the first toxoplasmosis-associated HLH during TIL therapy. It underscores the importance of distinguishing drug intolerance from true allergy, ensuring
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