A case report of hemophagocytic lymphohistiocytosis occurring during ibrutinib chemotherapy with a literature review.
[RATIONALE] Ibrutinib, a Bruton tyrosine kinase inhibitor, is widely used in chronic lymphocytic leukemia (CLL).
APA
Hou X, Wang M, et al. (2026). A case report of hemophagocytic lymphohistiocytosis occurring during ibrutinib chemotherapy with a literature review.. Medicine, 105(3), e45957. https://doi.org/10.1097/MD.0000000000045957
MLA
Hou X, et al.. "A case report of hemophagocytic lymphohistiocytosis occurring during ibrutinib chemotherapy with a literature review.." Medicine, vol. 105, no. 3, 2026, pp. e45957.
PMID
41559979
Abstract
[RATIONALE] Ibrutinib, a Bruton tyrosine kinase inhibitor, is widely used in chronic lymphocytic leukemia (CLL). Its association with secondary hemophagocytic lymphohistiocytosis (HLH) is exceedingly rare but potentially fatal.
[PATIENT CONCERNS] A 59-year-old male with CLL presented with recurrent fever and progressive splenomegaly.
[DIAGNOSES] Bone marrow biopsy confirmed CLL. Five months after ibrutinib (420 mg/day) initiation, progressive pancytopenia, hyperferritinemia, and hemophagocytosis on repeat marrow aspirate established HLH diagnosis.
[INTERVENTIONS] HLH-94 protocol (etoposide + dexamethasone) was initiated.
[OUTCOMES] The patient developed fungemia followed by massive cerebral infarction. Treatment was withdrawn due to deterioration, resulting in death.
[LESSONS] Ibrutinib may trigger HLH via immune dysregulation. Early recognition through vigilant monitoring of cytopenias, ferritin, and marrow hemophagocytosis is critical to improve survival.
[PATIENT CONCERNS] A 59-year-old male with CLL presented with recurrent fever and progressive splenomegaly.
[DIAGNOSES] Bone marrow biopsy confirmed CLL. Five months after ibrutinib (420 mg/day) initiation, progressive pancytopenia, hyperferritinemia, and hemophagocytosis on repeat marrow aspirate established HLH diagnosis.
[INTERVENTIONS] HLH-94 protocol (etoposide + dexamethasone) was initiated.
[OUTCOMES] The patient developed fungemia followed by massive cerebral infarction. Treatment was withdrawn due to deterioration, resulting in death.
[LESSONS] Ibrutinib may trigger HLH via immune dysregulation. Early recognition through vigilant monitoring of cytopenias, ferritin, and marrow hemophagocytosis is critical to improve survival.
MeSH Terms
Humans; Male; Lymphohistiocytosis, Hemophagocytic; Middle Aged; Adenine; Piperidines; Leukemia, Lymphocytic, Chronic, B-Cell; Fatal Outcome; Pyrimidines; Pyrazoles
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