J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://www.thejh.org

Case Report

Volume 11, Number 4, August 2022, pages 142-147

Immune Checkpoint Inhibitor-Induced Hemophagocytic Lymphohistiocytosis in a Patient With Squamous Cell Carcinoma

Figures

Figure 1. Patient’s ferritin levels over time with therapy. Patient responded quickly, but ferritin levels did not return to below normal even seven months after therapy.

Figure 2. Patient’s platelet over time with therapy. Patient’s thrombocytopenia improved more gradually and only after completion of four doses of etoposide. However, thrombocytopenia did eventually resolve seven months after therapy.

Table

**Table 1.** A Review of This Patient’s Laboratory Findings
	On/shortly after admission	After first dose of tocilizumab	After second dose of tocilizumab with first dose of etoposide	After second dose of etoposide	After third dose of etoposide	After fourth dose of etoposide	9 days after therapy	7 months after therapy
ANC: absolute neutrophil count; AST: aspartate transaminase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; IL-2: interleukin-2.
White blood cell (× 10³/µL)	0.9	1.5	1.0	1.0	0.8	0.6	2.0	4.8
ANC (× 10³/µL)	0.4	0.5	0.5	0.5	0.4	0.2	1.2	2.5
Hemoglobin (g/dL)	5.4	6.8	6.8	7.8	8.1	7.2	6.5	9.0
Platelet (× 10³/µL)	64	64	77	80	63	34	93	227
AST (U/L)	127	136	149	70	31	11	16	17
ALT (U/L)	53	41	79	84	63	24	58	19
Total bilirubin (mg/dL)	1.5	1.1	1.1	0.8	0.6	0.5	0.5	0.3
LDH (U/L)	1,950	2,298	1,891	1,013	582	373	306	240
Ferritin (ng/mL)	64,579	41,679	31,563	16,823	4,929	3,148	2,306	1,767
Fibrinogen (mg/dL)	99	70	51	73	105	147	350	467
D-dimer (ng/mL)	47,206	-	-	-	-	1,024
IL-2 levels	-	8,645	-	-	-	-