Cytokine adsorption is a promising tool in the therapy of hemophagocytic lymphohistiocytosis. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: Frimmel, Silvius; Hinz, Michael; Schipper, Jan; Bogdanow, Simon; Mitzner, Steffen; Koball, Sebastian
• Is Part Of: International journal of artificial organs. Volume 42:Issue 11(2019)
• Page Start: 658
• Page End: 664
• Publication Date: 2019-11
• Subjects: Hemophagocytic lymphohistiocytosis -- cytokine adsorption -- CytoSorb -- virus -- sepsis -- artificial kidney -- apheresis and detoxification techniques -- hemoperfusion; Artificial organs -- Periodicals; 617.956
• DOI: 10.1177/0391398819857444
• Languages: English
• ISSNs: 0391-3988

Abstract

Hemophagocytic lymphohistiocytosis is a life-threatening clinical syndrome caused by severe hypercytokinemia brought on by a highly stimulated but ineffective immune response. Animal studies and case series have demonstrated that a reduction in blood cytokine levels achieved with an extracorporeal adsorption cartridge that contains blood-compatible porous polymer beads (CytoSorb ® ) can effectively attenuate the inflammatory response during sepsis and possibly improve outcomes. We report a case series of two patients in which three episodes of severe hemophagocytic lymphohistiocytosis triggered by infections with herpesviridae were treated successfully with cytokine adsorption. A marked decrease in interleukin-6 plasma levels and a stable or decreasing need of vasopressor therapy were the most significant results of this treatment. Importantly, treatment was safe and well-tolerated, without any adverse events.