Ruxolitinib
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Cytomegalovirus and fungal lung infection: case report A case report of three patients described a 45-year-old woman, who developed cytomegalovirus (CMV) and fungal lung infection during treatment with ruxolitinib for secondary haemophagocytic lymphohistiocytosis (HLH). The woman was admitted to the department of haematology on 2 January 2018 with recurrent fever for 10 days. She had been diagnosed with peripheral T-cell lymphoma since January 2015. She had received CHOP-like chemotherapy regimens. Based on medical examination, abdominal enhanced CT scan, bone marrow puncture, bone marrow aspiration and flow cytometric analysis of bone marrow she was diagnosed with relapse of peripheral T-cell lymphoma and secondary HLH. She immediately started receiving ruxolitinib 5mg twice daily [route not stated] and amended HLH-94 protocol comprising etoposide and dexamethasone. Three days following treatment, her fever was controlled. Two weeks later, liver function and fibrinogen levels returned to normal, and ferritin levels dropped. Etoposide was discontinued after four doses (last dose on day 11 of therapy). Then, she received chemotherapy of pegaspargase, gemcitabine and oxaliplatin while continuing dexamethasone and ruxolitinib. After 30 days from the initiation of treatment, she developed a fever again. She was diagnosed with CMV and fungal lung infection based on results of her lung CT scan, whole blood CMV-DNA test and plasma galactomannan test. The lymphoma and secondary HLH were well controlled. The infections were attributed to ruxolitinib therapy. The woman was treated with ganciclovir and amphotericin-B [amphotericin]. She went back to the local hospital with sustained treatment of ganciclovir and amphotericin-B. Two weeks after discharge, she died due to failure of respiration and disseminated intravascular coagulation. Wang H, et al. Low dose ruxolitinib plus HLH-94 protocol: A potential choice for secondary HLH. Seminars in Hematology 57: 26-30, No. 1, Jan 2020. Available from: 803502769 URL: http://doi.org/10.1053/j.seminhematol.2018.07.006
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Reactions 26 Sep 2020 No. 1823
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