{"id":"https://openalex.org/W7204094640","doi":"https://doi.org/10.2169/internalmedicine.7688-26","title":"Hemophagocytic Lymphohistiocytosis as a Clinical Harbinger of Rapid Disease Progression in Multiple Myeloma During Daratumumab-Based Therapy","display_name":"Hemophagocytic Lymphohistiocytosis as a Clinical Harbinger of Rapid Disease Progression in Multiple Myeloma During Daratumumab-Based Therapy","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7204094640","doi":"https://doi.org/10.2169/internalmedicine.7688-26","pmid":"https://pubmed.ncbi.nlm.nih.gov/42649064"},"language":"en","primary_location":{"id":"doi:10.2169/internalmedicine.7688-26","doi":"https://doi.org/10.2169/internalmedicine.7688-26","is_oa":true,"landing_page_url":"https://doi.org/10.2169/internalmedicine.7688-26","pdf_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7688-26/_pdf","source":{"id":"https://openalex.org/S154471048","display_name":"Internal Medicine","issn_l":"0918-2918","issn":["0918-2918","1349-7235"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313351","host_organization_name":"The Japanese Society of Internal Medicine","host_organization_lineage":["https://openalex.org/P4310313351"],"host_organization_lineage_names":["The Japanese Society of Internal Medicine"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7688-26/_pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5103009383","display_name":"Hisaharu Shikata","orcid":"https://orcid.org/0000-0001-5837-8645","observed_orcids":["https://orcid.org/0000-0001-5837-8645","https://orcid.org/0000-0002-7605-7615"]},"institutions":[{"id":"https://openalex.org/I4210110860","display_name":"Uwajima City Hospital","ror":"https://ror.org/019x26026","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210110860"]},{"id":"https://openalex.org/I4405285482","display_name":"Uwajima Hospital","ror":"https://ror.org/05hc02p18","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210132540","https://openalex.org/I4405285482"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Hisaharu Shikata","raw_affiliation_strings":["Department of Hematology, Uwajima City Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hematology, Uwajima City Hospital, Japan","institution_ids":["https://openalex.org/I4210110860","https://openalex.org/I4405285482"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103230835","display_name":"Masahiko Kaneko","orcid":"https://orcid.org/0000-0001-6639-3159","observed_orcids":["https://orcid.org/0000-0001-6639-3159","https://orcid.org/0000-0002-8039-5529"]},"institutions":[{"id":"https://openalex.org/I4210110860","display_name":"Uwajima City Hospital","ror":"https://ror.org/019x26026","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210110860"]},{"id":"https://openalex.org/I4405285482","display_name":"Uwajima Hospital","ror":"https://ror.org/05hc02p18","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210132540","https://openalex.org/I4405285482"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Masahiko Kaneko","raw_affiliation_strings":["Department of Hematology, Uwajima City Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hematology, Uwajima City Hospital, Japan","institution_ids":["https://openalex.org/I4210110860","https://openalex.org/I4405285482"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5034117815","display_name":"Shoichi Matsukage","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210110860","display_name":"Uwajima City Hospital","ror":"https://ror.org/019x26026","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210110860"]},{"id":"https://openalex.org/I4405285482","display_name":"Uwajima Hospital","ror":"https://ror.org/05hc02p18","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210132540","https://openalex.org/I4405285482"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Shoichi Matsukage","raw_affiliation_strings":["Department of Pathology, Uwajima City Hospital, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Uwajima City Hospital, Japan","institution_ids":["https://openalex.org/I4210110860","https://openalex.org/I4405285482"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.55435023,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10649","display_name":"Multiple Myeloma Research and Treatments","score":0.8931000232696533,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10649","display_name":"Multiple Myeloma Research and Treatments","score":0.8931000232696533,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11616","display_name":"Autoimmune and Inflammatory Disorders Research","score":0.08669999986886978,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10185","display_name":"Lymphoma Diagnosis and Treatment","score":0.003000000026077032,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hemophagocytic-lymphohistiocytosis","display_name":"hemophagocytic lymphohistiocytosis","score":1.0},{"id":"https://openalex.org/keywords/multiple-myeloma","display_name":"multiple myeloma","score":1.0},{"id":"https://openalex.org/keywords/daratumumab","display_name":"daratumumab","score":1.0},{"id":"https://openalex.org/keywords/anti-cd38-therapy","display_name":"anti-CD38 therapy","score":0.8899999856948853},{"id":"https://openalex.org/keywords/lenalidomide","display_name":"lenalidomide","score":0.8489999771118164},{"id":"https://openalex.org/keywords/dexamethasone","display_name":"dexamethasone","score":0.8640000224113464},{"id":"https://openalex.org/keywords/disease-progression","display_name":"disease progression","score":0.718999981880188},{"id":"https://openalex.org/keywords/relapse","display_name":"relapse","score":0.40799999237060547}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9793000221252441},{"id":"https://openalex.org/C2776364478","wikidata":"https://www.wikidata.org/wiki/Q467635","display_name":"Multiple myeloma","level":2,"score":0.8424999713897705},{"id":"https://openalex.org/C2779079688","wikidata":"https://www.wikidata.org/wiki/Q1642170","display_name":"Hemophagocytic lymphohistiocytosis","level":3,"score":0.8256000280380249},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4221000075340271},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.3912999927997589},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.3549000024795532},{"id":"https://openalex.org/C2780648854","wikidata":"https://www.wikidata.org/wiki/Q2745824","display_name":"Immunopathology","level":2,"score":0.3479999899864197},{"id":"https://openalex.org/C2779609412","wikidata":"https://www.wikidata.org/wiki/Q203174","display_name":"Thalidomide","level":3,"score":0.328900009393692},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.31769999861717224},{"id":"https://openalex.org/C2780174970","wikidata":"https://www.wikidata.org/wiki/Q1411740","display_name":"Histiocytosis","level":3,"score":0.29190000891685486},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.28929999470710754},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2502000033855438}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.2169/internalmedicine.7688-26","doi":"https://doi.org/10.2169/internalmedicine.7688-26","is_oa":true,"landing_page_url":"https://doi.org/10.2169/internalmedicine.7688-26","pdf_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7688-26/_pdf","source":{"id":"https://openalex.org/S154471048","display_name":"Internal Medicine","issn_l":"0918-2918","issn":["0918-2918","1349-7235"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313351","host_organization_name":"The Japanese Society of Internal Medicine","host_organization_lineage":["https://openalex.org/P4310313351"],"host_organization_lineage_names":["The Japanese Society of Internal Medicine"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal Medicine","raw_type":"journal-article"},{"id":"pmid:42649064","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42649064","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal medicine (Tokyo, Japan)","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.2169/internalmedicine.7688-26","doi":"https://doi.org/10.2169/internalmedicine.7688-26","is_oa":true,"landing_page_url":"https://doi.org/10.2169/internalmedicine.7688-26","pdf_url":"https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7688-26/_pdf","source":{"id":"https://openalex.org/S154471048","display_name":"Internal Medicine","issn_l":"0918-2918","issn":["0918-2918","1349-7235"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","medline","norway-1","poland-40","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313351","host_organization_name":"The Japanese Society of Internal Medicine","host_organization_lineage":["https://openalex.org/P4310313351"],"host_organization_lineage_names":["The Japanese Society of Internal Medicine"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Internal Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9922999739646912}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204094640.pdf","grobid_xml":"https://content.openalex.org/works/W7204094640.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4224325085","https://openalex.org/W3153780955","https://openalex.org/W4297541868","https://openalex.org/W7115019252","https://openalex.org/W1995732633","https://openalex.org/W4400318570","https://openalex.org/W4406366476","https://openalex.org/W3088160950","https://openalex.org/W7125515947","https://openalex.org/W2921795031"],"abstract_inverted_index":{"Hemophagocytic":[0],"lymphohistiocytosis":[1],"(HLH)":[2],"is":[3,90],"rare":[4],"in":[5,81],"patients":[6,82],"with":[7,28,32,83],"multiple":[8],"myeloma":[9],"(MM),":[10],"and":[11,30,35,97],"its":[12],"significance":[13],"during":[14,66],"anti-CD38-based":[15],"therapy":[16,68],"remains":[17],"unclear.":[18],"We":[19],"report":[20],"the":[21,53,62],"case":[22,60],"of":[23,57,77,88],"a":[24,73],"76-year-old":[25],"man":[26],"diagnosed":[27],"MM":[29],"treated":[31],"daratumumab,":[33],"lenalidomide,":[34],"dexamethasone":[36],"who":[37],"developed":[38],"HLH":[39,65,89],"before":[40,101],"an":[41],"aggressive":[42],"clinical":[43,75],"relapse.":[44],"Autopsy":[45],"revealed":[46],"diffuse":[47],"extramedullary":[48],"plasma":[49],"cell":[50],"infiltration,":[51],"despite":[52],"minimal":[54],"morphological":[55],"evidence":[56],"hemophagocytosis.":[58],"This":[59],"highlights":[61],"fact":[63],"that":[64],"immune-modifying":[67],"should":[69],"be":[70],"recognized":[71],"as":[72],"critical":[74],"harbinger":[76],"rapid":[78],"disease":[79,95],"progression":[80,96],"CLL.":[84],"The":[85],"early":[86],"identification":[87],"vital":[91],"for":[92],"detecting":[93],"imminent":[94],"initiating":[98],"immediate":[99],"intervention":[100],"massive":[102],"systemic":[103],"involvement":[104],"occurs.":[105]},"counts_by_year":[],"updated_date":"2026-10-09T09:14:12.587421","created_date":"2026-08-25T00:00:00"}