PMC6443545_01
A bone marrow examination showed hypocellular marrow with histiocytic hyperplasia and hemophagocytic macrophage infiltration (indicated with the arrow).
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A bone marrow examination showed hypocellular marrow with histiocytic hyperplasia (macrophages, 1.6%) and hemophagocytic macrophage infiltration (Fig. 1).
The clinical course after the first dose of pembrolizumab showing the dose and duration of steroid therapy and its efficacy for hemophagocytic lymphohistiocytosis. The high fever immediately resolved, and the serum lactate dehydrogenase and hemoglobin levels remarkably improved.
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Because his laboratory data worsened within 3 days, as shown in Fig. 2, we started steroid pulse therapy with antibiotics.
Computed tomography findings of the chest before pembrolizumab treatment (A). A mass can be observed in the right lower lobe of the lung. Mediastinal lymphadenopathy markedly regressed after glucocorticoid treatment for autoimmune hemolytic anemia and hemophagocytic lymphohistiocytosis as complications of pembrolizumab on day 73 after the first dose (B).
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CT of his chest showed remarkable tumor shrinkage, which has been maintained without disease recurrence (Fig. 3).