Abdulrahman Al-Mashdali։ Immune Checkpoint Inhibitor Associated HLH
Abdulrahman Al-Mashdali, Hematology Chief Fellow at Hamad Medical Corporation, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Clinical Medicine Insights: Oncology, adding:
”Excited to share our latest work on immune checkpoint inhibitor–associated hemophagocytic lymphohistiocytosis (ICI-HLH) — a rare but potentially fatal immune-related toxicity that is increasingly recognized in clinical practice.
In this systematic review, we analyzed 96 patients from 78 published reports, providing one of the most comprehensive patient-level summaries of ICI-associated HLH to date.
A few key findings:
- HLH developed early, after a median of 2 ICI cycles and 30 days from treatment initiation.
- Fever (97.9 percent) and cytopenias (97.8 percent) were the dominant clinical features, with marked hyperferritinemia.
- Diagnostic approaches were highly heterogeneous, including HLH-2004 criteria, HScore, combined criteria, and clinician-based
diagnosis. - Although 83 percent of patients improved or achieved resolution, mortality remained substantial at 25.3 percent.
- ICI rechallenge was rarely reported and was associated with recurrent HLH in 3 of 7 patients.
Our findings emphasize the importance of maintaining a high index of suspicion for HLH in patients receiving ICIs who develop persistent fever, cytopenias, and markedly elevated ferritin, as well as the need for earlier multidisciplinary assessment and more standardized diagnostic and treatment strategies.
I am very grateful to all my coauthors and collaborators for their valuable contributions Fatihelmgib Mohamed Mujahid Osama Abdelraof Shehab Mohamed Mohammed Elmourtada Abdulgayoom, thoughtful discussions, and continued support throughout this project.”
Title: Immune Checkpoint Inhibitor–Associated Hemophagocytic Lymphohistiocytosis: A Systematic Review
Authors: Abdulrahman F. Al-Mashdali, Fatihelmgib Mohamed, Marwa Osman, Mujahid O. Abdelraof, Mohammed Abdulgayoom, Shehab F. Mohamed
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