Interferon-γ blockade in CD19 CART cell therapy-induced secondary macrophage activation syndrome/hemophagocytic lymphohistiocytosis

Abstract Chimeric antigen receptor (CAR) T-cell therapy has emerged as a highly effective therapy for hematological malignancies. Macrophage activation syndrome/hemophagocytic lymphohistiocytosis (MAS/HLH) is one of the most serious adverse events of CART-cell therapy. We report a case of CD19+ B ALL patient who was treated with autologous CD19-CART cells and developed a life-threatening secondary MAS/HLH. Her MAS/HLH was successfully salvaged treated by blocking Interferon-γ using emapalumab. Our case showed that emapalumab was a good option for the treatment of patients in CART cell therapy-induced secondary MAS/HLH without deleterious effect on the efficacy of CART cells in short term. It gave clinicians new inspiration.