Multitarget therapy for pembrolizumab-induced refractory hemophagocytic lympho histiocytosis

Abstract

Pembrolizumab-induced hemophagocytic lymphohistiocytosis (HLH) has rarely been reported, and it has no established treatment. The case of a 52-year-old woman with refractory pembrolizumab-induced HLH is presented. Her stage IV squamous cell lung cancer was treated using carboplatin/nab paclitaxel and pembrolizumab. After two cycles of treatment, Stevens-Johnson syndrome developed, followed by HLH. The HLH was refractory and did not improve with high-dose corticosteroids and cyclosporine A, but it improved with the addition of mycophenolate mofetil.

Keywords

• Hemophagocytic lymphohistiocytosis
• Immune-related adverse events
• Mycophenolate mofetil
• Cyclosporine A