Journal Article Review Ppublish
PubMed: 40158936 DOI: 10.1016/j.hoc.2025.02.005
Immune Effector Cell-associated Hemophagocytic Lymphohistiocytosis-like Syndrome (IEC-HS).
Hematol Oncol Clin North Am 39(3):617-643
Authors: Jerry C Lee, William T Johnson, Melissa Hines, Nirali N Shah
Affiliations
- Hematology, Blood and Marrow Transplantation, and Cellular Therapy Program, Division of Hematology/Oncology, Department of Medicine, University of California, UCSF Box 0345, 400 Parnassus Avenue, San Francisco, CA 94143, USA.
- Lymphoma Service and Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, MS #734262 Danny Thomas Place, Memphis, TN 38105, USA.
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD, USA.
Abstract
Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS) is a complication of adoptive cell therapy. Presenting with clinical manifestations of hyperinflammation and surrogate indicators of hyperinflammation such as elevations in serum ferritin and hepatic transaminases, decreasing cell counts, and hypofibrinogenemia, IEC-HS resembles primary and other forms of secondary hemophagocytic lymphohistiocytosis. Nonetheless, this is an iatrogenic complication resulting from the induction of hyperinflammatory pathways during T-cell-mediated anticancer targeting. Distinct from cytokine release syndrome, IEC-associated neurotoxicity syndrome, and IEC-associated hematotoxicity, IEC-HS can be life-threatening. Identification of IEC-HS, optimization of treatment strategies, and use of supportive care are critical to improving outcomes.
MeSH
Cells, Hematology, Therapeutics, Medical Oncology, Lymphohistiocytosis, Hemophagocytic