PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH
Treatment with immune checkpoint inhibitors (ICI) such as carrizumab leads to immune-mediated adverse effects including severe acute graft versus host disease (aGVHD) and secondary hemophagocytic syndrome (sHLH). Herein, we present two cases where aGVHD and sHLH developed after ICI administration, w...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2022/1705905 |
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| author | Zhi zhuo Du Mi Zhou Jing Ling Lan Cao Lingjun Kong Shengqin Cheng Peifang Xiao Shaoyan Hu |
| author_facet | Zhi zhuo Du Mi Zhou Jing Ling Lan Cao Lingjun Kong Shengqin Cheng Peifang Xiao Shaoyan Hu |
| author_sort | Zhi zhuo Du |
| collection | DOAJ |
| description | Treatment with immune checkpoint inhibitors (ICI) such as carrizumab leads to immune-mediated adverse effects including severe acute graft versus host disease (aGVHD) and secondary hemophagocytic syndrome (sHLH). Herein, we present two cases where aGVHD and sHLH developed after ICI administration, which was treated using methylprednisolone (MP). They developed high-grade fever complicated with liver dysfunction and diarrhea 1 day after ICI administration. Treatment with MP does not alleviate symptoms because of steroid resistance. Hyperbilirubinemia, rash with blisters, and watery diarrhea showed severe aGVHD. Hyperferritinemia, hypertriglyceridemia, and cytopenias suggested the diagnosis of HLH and met the criteria for sHLH diagnosis. They were thus administered intravenous high-dose MP, methotrexate (MTX), basiliximab, ruxolitinib, etc, which resolved these symptoms. |
| format | Article |
| id | doaj-art-8d71638a51b443ed93907b463b6b3e4b |
| institution | Kabale University |
| issn | 2090-6579 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-8d71638a51b443ed93907b463b6b3e4b2025-02-03T05:58:00ZengWileyCase Reports in Hematology2090-65792022-01-01202210.1155/2022/1705905PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLHZhi zhuo Du0Mi Zhou1Jing Ling2Lan Cao3Lingjun Kong4Shengqin Cheng5Peifang Xiao6Shaoyan Hu7Children’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityChildren’s Hospital of Suzhou UniversityTreatment with immune checkpoint inhibitors (ICI) such as carrizumab leads to immune-mediated adverse effects including severe acute graft versus host disease (aGVHD) and secondary hemophagocytic syndrome (sHLH). Herein, we present two cases where aGVHD and sHLH developed after ICI administration, which was treated using methylprednisolone (MP). They developed high-grade fever complicated with liver dysfunction and diarrhea 1 day after ICI administration. Treatment with MP does not alleviate symptoms because of steroid resistance. Hyperbilirubinemia, rash with blisters, and watery diarrhea showed severe aGVHD. Hyperferritinemia, hypertriglyceridemia, and cytopenias suggested the diagnosis of HLH and met the criteria for sHLH diagnosis. They were thus administered intravenous high-dose MP, methotrexate (MTX), basiliximab, ruxolitinib, etc, which resolved these symptoms.http://dx.doi.org/10.1155/2022/1705905 |
| spellingShingle | Zhi zhuo Du Mi Zhou Jing Ling Lan Cao Lingjun Kong Shengqin Cheng Peifang Xiao Shaoyan Hu PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH Case Reports in Hematology |
| title | PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH |
| title_full | PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH |
| title_fullStr | PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH |
| title_full_unstemmed | PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH |
| title_short | PD-1 Checkpoint Blockade in Patients for Acute Myeloid Leukemia after HSCT Relapse Resulted in Severe GVHD and sHLH |
| title_sort | pd 1 checkpoint blockade in patients for acute myeloid leukemia after hsct relapse resulted in severe gvhd and shlh |
| url | http://dx.doi.org/10.1155/2022/1705905 |
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