Conclusion
HLH, toxicity
Our study suggests that escalating the dose of ruxolitinib can provide better resolution of refractory HLH with tolerable toxicity when the general dose fails. Upon a more comprehensive analysis to our data, it’s noted that ruxolitinib alone may not be enough for all patients and that addition of low dose chemotherapy (such as etoposide) may be helpful and is tolerated. The levels of sCD25 (with a cut-off of 10000pg/ml) may serve as an indicator for early consideration of chemotherapy during treatment of HLH. This is the first comprehensive study on the use of dose-escalating ruxolitinib in the treatment of HLH. Larger systematically protocol-driven prospective clinical trials and further mechanism studies are still necessary to validate our findings.