Severe Cytokine Release Syndrome and Hemophagocytic Lymphohistiocytosis

Brentuximab vedotin (BV) and nivolumab are increasingly utilized as a novel regimen in patients with relapsed/refractory classical Hodgkin lymphoma (cHL). A 26-year-old male presented to the hospital with refractory diabetic ketoacidosis and multiple electrolyte abnormalities, 9 days after the first...

Full description

Saved in:
Bibliographic Details
Published inJournal of blood medicine Vol. 14; p. 29
Main Authors Mosalem, Osama, Pai, Tanmayi, Alqawasma, Mohammed, Shaikh, Marwan, Li, K.David, Moustafa, Muhamad Alhaj
Format Journal Article
LanguageEnglish
Published Dove Medical Press Limited 31.01.2024
Subjects
Biological products
Brentuximab vedotin
Cytokines
Diseases
Immunotherapy
Non-Hodgkin's lymphomas
Palliative treatment
Relapse
Online AccessGet full text

Cover

More Information
Summary:Brentuximab vedotin (BV) and nivolumab are increasingly utilized as a novel regimen in patients with relapsed/refractory classical Hodgkin lymphoma (cHL). A 26-year-old male presented to the hospital with refractory diabetic ketoacidosis and multiple electrolyte abnormalities, 9 days after the first dose of brentuximab vedotin and nivolumab for recurrent classical Hodgkin lymphoma. During his hospitalization, he developed multi-organ failure. His workup showed elevated cytokine levels concerning severe cytokine release syndrome (CRS) and hemophagocytic lymphohistiocytosis (HLH)-like syndrome. Despite treatment with CRS- and HLH- directed therapies, his clinical status deteriorated due to ongoing multifactorial shock and worsening multi-organ dysfunction, and comfort care measures were eventually pursued. To our knowledge, there have been no other cases reported of HLH-like syndrome after the combination of BV and nivolumab in patients with cHL. This case of a fatal adverse event following one dose of BV and nivolumab underscores the vital need for close monitoring of patients receiving this treatment regimen. Keywords: immunotherapy, immune-related adverse event, antibody drug conjugate, CRS
ISSN:1179-2736
1179-2736