Hybrid ImmunoTherapy (ATG/Dexamethasone/Etoposide) for Hemophagocytic Lymphohistiocytosis: The HIT-HLH trial
Michael Jordan, MD
Cincinnati Children’s Hospital Medical Center – Cincinnati, Ohio USA
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In recent years significant progress has been made in the treatment of hemophagocytic lymphohistiocytosis (HLH). However, outcomes for children with HLH are often still quite poor. Many children fail to respond completely, or even adequately, to the current standard treatment, which is based on a chemotherapy drug called etoposide. An alternative approach to treating HLH has been reported, which is based on a different drug called anti-thymocyte globulin (ATG). These two approaches have a similar success rate, but, they appear to have very different strengths and weaknesses. Therefore, we suspect that an approach which combines aspects of these two strategies (a ‘hybrid’ approach incorporating both ATG and etoposide), will be superior to either one alone. We have developed a clinical trial called the “Hybrid Immunotherapy for HLH,” or the “HIT-HLH trial,” to test whether such an approach is feasible. The trial is currently open at Cincinnati Children’s Hospital and we are also working to open it at up to six other children’s hospitals in North America. We believe that the HIT-HLH trial will be a first step towards improving the therapy and the outcomes for children with HLH.