Scientific Letters
Vol. 18 No. 1 (2026): Mediterranean Journal of Hematology and Infectious Diseases
https://doi.org/10.4084/MJHID.2026.073

Allogeneic Hematopoietic Stem Cell Transplantation in Hemophagocytic LymphohistiocytosisTwo Sides of the Locket: Trigger or Cure?

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Published: September 1, 2026
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Hemophagocytic Lymphohistiocytosis, Allogeneic Bone Marrow Transplantation, Endothelial Syndromes, Inflammation, Familial Hemophagocytic Lymphohistiocytosis, Ruxolitinib

Authors

Ahmet Alparslan Ceran
aalparslanceran@gmail.com
Gazi University Department of Hematology, Türkiye.
Irem Eser Sarı
Gazi University Department of Hematology, Türkiye.
Tugce Sevval Yildiz
Gazi University Department of Hematology, Türkiye.
Ahmet Seyhanli
Gazi University Department of Hematology, Türkiye.
Zeynep Arzu Yegin
Gazi University Department of Hematology, Türkiye.
Zubeyde Nur Ozkurt
Gazi University Department of Hematology, Türkiye.
Abdullah Munci Yagci
Gazi University Department of Hematology, Türkiye.

Allogeneic hematopoietic stem cell transplantation (alloHSCT) represents a paradoxical role in hemophagocytic lymphohistiocytosis (HLH): curative in primary disease yet potentially triggering secondary HLH in the posttransplant setting. We report two adult cases illustrating this duality. The first case developed life-threatening secondary HLH on day +40 following haploidentical alloHSCT, presenting with extreme hyperferritinemia and procalcitonin elevation mimicking septic shock, successfully treated with dexamethasone, ruxolitinib, and plasma exchange. The second case underwent alloHSCT as definitive therapy for familial HLH harboring a UNC13D variant, achieving complete remission despite posttransplant EBV reactivation and lymphoproliferative disorder. These cases highlight the diagnostic challenges and therapeutic complexity of HLH within the transplant continuum.



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Ethics Approval

allogeneic hematopoietic stem cell transplantation, Hemophagocytic Lymphohistiocytosis, Ruxolitinib, Endothelial Syndromes, Familial Hemophagocytic Lymphohistiocytosis, Inflammation

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No funding was received for this research

How to Cite



“Allogeneic Hematopoietic Stem Cell Transplantation in Hemophagocytic LymphohistiocytosisTwo Sides of the Locket: Trigger or Cure?” (2026) Mediterranean Journal of Hematology and Infectious Diseases, 18(1), p. e2026073. doi:10.4084/MJHID.2026.073.
Copyright (c) 2026 Ahmet Alparslan Ceran, Irem Eser Sarı, Tugce Sevval Yildiz, Ahmet Seyhanli, Zeynep Arzu Yegin, Zubeyde Nur Ozkurt, Abdullah Munci Yagci Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.