Alternative Therapies for Cytokine Storm Syndromes

Abstract

Cytokine storm syndromes (CSS) are a challenge for physicians, both due to their aggressive nature and the need for tailored treatment for each patient. While hematopoietic stem cell transplantation (HSCT) has changed the fate of primary hemophagocytic lymphohistiocytosis (HLH), and biologics of macrophage activation syndrome (MAS)/secondary HLH, there is still a need for adjunctive treatment to better manage these patients. The principles of treatment are summarized in Table 1. This chapter discusses the available alternative treatments (biologics discussed in elsewhere). Unfortunately, except for corticosteroids, there is not a lot of solid evidence for the effectiveness of most of these agents. Biologics have become an essential part of the treatment in MAS. However for all these treatment modalities and corticosteroids, there is a lack of controlled studies to guide optimal dosage and duration of therapy.