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Adjustments to pharmacologic therapies for hemophagocytic lymphohistiocytosis while on extracorporeal support
Author(s) -
Weyand Angela C.,
Barbaro Ryan P.,
Walkovich Kelly J.,
Frame David G.
Publication year - 2021
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.29007
Subject(s) - medicine , hemophagocytic lymphohistiocytosis , extracorporeal , extracorporeal membrane oxygenation , renal replacement therapy , intensive care medicine , organ dysfunction , context (archaeology) , plasmapheresis , life support , dosing , hemofiltration , surgery , immunology , disease , sepsis , hemodialysis , paleontology , antibody , biology
Hemophagocytic lymphohistiocytosis (HLH) is an immune dysregulatory syndrome characterized by severe inflammation and end‐organ damage. Due to significant organ dysfunction, patients often require extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). In this report, we describe consideration for adjusting treatment in the context of extracorporeal organ support. We describe agents commonly used and dosing adjustments made in light of extracorporeal organ support. We report six cases that illustrate the feasibility of initiating standard HLH therapies in patients requiring these modalities.