Hemoperfusion for Hodgkin lymphoma-associated hemophagocytic lymphohistiocytosis

Intern Med. 2014;53(20):2365-8. doi: 10.2169/internalmedicine.53.2457. Epub 2014 Oct 15.

Abstract

Hemophagocytic lymphohistiocytosis (HLH), which is associated with various underlying conditions, is characterized by hypercytokinemia. Because it is frequently lethal, immediate mitigation of the hypercytokinemia is vital to save patients, particularly when treatments for the patient's underlying condition are ineffective on HLH. We herein present a case of Hodgkin lymphoma associated with HLH in which the HLH did not improve even after chemotherapy. We attempted to save the patient using hemoperfusion with a polymyxin B-immobilized fiber column to remove cytokines; following this treatment, the patient rapidly recovered. Hemoperfusion may be a strategic method to rescue intractable HLH patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / therapeutic use
  • Cytokines / antagonists & inhibitors*
  • Dacarbazine / therapeutic use
  • Doxorubicin / therapeutic use
  • Hemoperfusion / methods*
  • Hodgkin Disease / complications*
  • Hodgkin Disease / drug therapy
  • Humans
  • Lymphohistiocytosis, Hemophagocytic / complications*
  • Lymphohistiocytosis, Hemophagocytic / drug therapy
  • Lymphohistiocytosis, Hemophagocytic / therapy*
  • Male
  • Vinblastine / therapeutic use

Substances

  • Cytokines
  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin

Supplementary concepts

  • ABVD protocol