Myeloma-associated hemophagocytic lymphohistiocytosis - A comprehensive case study and a novel chemotherapy-free approach with anakinra

EJHaem. 2024 Jul 4;5(5):1057-1062. doi: 10.1002/jha2.975. eCollection 2024 Oct.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is an immune response syndrome characterized by excessive inflammation and tissue destruction. A limited number of cases involving HLH patients with concomitant multiple myeloma (MM), leading to significant mortality, have been documented, underscoring the importance of timely diagnosis. We present the case of a 78-year-old previously healthy male admitted to our hospital with a newly diagnosed MM. Subsequently, he was diagnosed with HLH and received treatment with anakinra, intravenous immunoglobulin, and dexamethasone. This case report highlights the unique aspect of being the first documented instance of myeloma-associated HLH treated with anakinra.

Keywords: chemotherapy; immunotherapy; macrophages; malignancy; thrombocytopenia.