随着嵌合抗原受体 T 细胞疗法的出现，了解它们在噬血细胞性淋巴组织细胞增多症发展中的作用变得越来越复杂。我们描述了一名患有 Epstein-Barr 病毒阳性弥漫性大 B 细胞淋巴瘤的年轻患者的病例，该患者接受了 axicabtagene ciloleucel 治疗。患者出现进行性血细胞减少，并在输注后第 73 天达到噬血细胞性淋巴组织细胞增多症的标准。骨髓评估显示有噬血细胞，但没有克隆 B 细胞的证据。该患者接受托珠单抗、地塞米松、依托泊苷和阿那白滞素治疗，最终病情有所改善。不幸的是，患者因感染去世。疾病进展在死后得到证实。本病例报告探讨了嵌合抗原受体 T 细胞治疗后高炎症综合征的鉴别诊断，并强调了这种治疗在富含 T 细胞/组织细胞背景的患者中疗效降低。

With the advent of chimeric antigen receptors T-cell therapy, understanding their role in the development of hemophagocytic lymphohistiocytosis has become increasingly complex. We describe a case of a young patient with Epstein-Barr virus-positive diffuse large B-cell lymphoma, who was treated with axicabtagene ciloleucel. The patient developed progressive cytopenia and, on Day 73 post-infusion, met criteria for hemophagocytic lymphohistiocytosis. Bone marrow evaluation revealed hemophagocytosis without evidence of clonal B cells. The patient was treated with tocilizumab, dexamethasone, etoposide and anakinra, which eventually led to improvement. Unfortunately, the patient succumbed to an infection. Disease progression was confirmed posthumously.This case report explores the differential diagnosis of hyperinflammatory syndromes following chimeric antigen receptor T-cell therapy and highlights the reduced efficacy of this treatment in patients with a T-cell/histiocyte-rich background.