Reactions Weekly

, Volume 1780, Issue 1, pp 245–245 | Cite as

Multiple drugs

Haemophagocytic lymphohistiocytosis and lack of drug effect: 3 case reports
Case report
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An event is serious (based on the ICH definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * other medically important event

In a case series, three patients including two men and one woman aged 61−77 years were described, who developed haemophagocytic lymphohistiocytosis (HLH) during treatment with ibrutinib. Additionally, these 3 patients exhibited lack of effect and died despite treatment with immune globulin, etoposide, dexamethasone, cyclophosphamide, ciclosporin or unspecified steroids [not all routes and dosages stated].

Case 1: A 77-year-old woman, who had lymphoplasmacytic lymphoma (LPL), had been receiving treatment with ibrutinib. Two weeks after starting ibrutinib, she developed pancytopenia, fevers, hyperbilirubinaemia and elevated liver enzymes. A bone marrow biopsy showed marked haemophagocytosis; however, LPL was not evident. Laboratory findings revealed the following: elevated...


  1. Ambinder AJ, et al. Ibrutinib-associated hemophagocytic lymphohistiocytosis: A case series from Johns Hopkins. American Journal of Hematology 94: E296-E299, No. 11, Nov 2019. Available from: URL: - USA

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© Springer International Publishing AG 2019

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