From:  Immune checkpoint inhibitor-induced hemophagocytic lymphohistiocytosis in lung cancer: a case series

 Timeline of HLH presentation and steroid response in ICI therapy.

Timeline eventCase 1: SCLC, atezolizumabCase 2: NSCLC, pembrolizumabCase 3: endometrial CA, pembrolizumab
Received chemo/ICIDay 0: carboplatin, etoposide, atezolizumabDay 0: pembrolizumabDay 0: pembrolizumab
Day of onset of HLH symptomsDay 19: fatigue, fever, nauseaDay 25: fever, fatigue, SOB, nausea, vomiting~120 days post-treatment: fatigue, fever, night sweats
Day steroid startedDay 19Day 25Day 120
Final outcomeImproved in 2 weeks; continued cancer follow-upInitial improvement; HLH recurrence after rechallenge; transitioned to hospiceImproved within 1 week; labs normalized

ICI: immune checkpoint inhibitor; HLH: hemophagocytic lymphohistiocytosis.