Immunotherapy-related secondary hemophagocytosis in a glioblastoma patient: response to cytokine-directed therapy

Alan Ö., Bulbul M. C., Enlice M. A., Mandel N. M.

IMMUNOTHERAPY, cilt.17, sa.1, ss.11-17, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1080/1750743x.2025.2451604
  • Dergi Adı: IMMUNOTHERAPY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.11-17
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

ABSTRACT

Hemophagocytic Lymphohistiocytosis (HLH) is a severe and potentially life-threatening condition characterized

by an excessive and uncontrolled activation of the immune system. ICI-related hemophagocytic

lymphohistiocytosis (irHLH) is a rare immune-related adverse event with an incidence of 0.03% to 0.4%.

Although rare, it can be potentially lethal, with a high mortality rate of up to 50% in some cases. We

present a patient with recurrent glioblastoma who developed Hemophagocytic Lymphohistiocytosis s a

result of nivolumab treatment and was subsequently managed with cytokine-directed therapy (tocilizumab).

Early diagnosis and treatment of Hemophagocytic Lymphohistiocytosis (HLH) associated with

immune checkpoint inhibitors (ICIs) are indeed crucial due to the potentially life-threatening nature of

the condition.Cytokine-based treatments (such as anti-IL-6) may be appropriate for patients who do not

respond to high-dose steroids.

PLAIN LANGUAGE SUMMARY

This case report describes a 44-year-old man who experienced an immune-related adverse event,

specifically Hemophagocytic Lymphohistiocytosis (HLH), following immunotherapy for recurrent glioblastoma.

He initially presented with persistent fever and lethargy, and further testing confirmed the

immune checkpoint inhibitor-related event. High-dose dexamethasone and anti-IL-6 therapy (tocilizumab)

were administered, resulting in fever resolution and improvement in laboratory findings.

However, his clinical condition and disease progressively worsened. Unfortunately, he passed away

due to disease progression.