A 64-year-old woman was treated with Sindillizumab immunotherapy for classic Hodgkin lymphoma. After 7 cycles, the patient developed fever, fatigue, poor appetite, and other symptoms. Auxiliary examination after admission showed that hemoglobin, platelets, white blood cells, and fibrinogen decreased, liver enzymes increased, serum ferritin increased significantly (3 727.56 μg·L^-1), and spleen enlargement, which was finally considered to be sindilizumab associated hemophagic cell syndrome. The patient was given methylprednisolone sodium succinate 60 mg·d^-1 intravenously for 2 days, 40 mg·d^-1 intravenously for 4 days, and 30  mg·d^-1 intravenously for 1 day, and their symptoms improved significantly, and the temperature, blood count, aminotransferase and other indicators gradually returned to normal. After discharge, she was changed to prednisone 30 mg·d^-1 oral therapy, and the dose was reduced by 10 mg per week until withdrawal. The patient did not restart sindilizumab after discharge, and the serum ferritin gradually returned to normal level during follow-up, and no hemophagocytic syndrome-related symptoms appeared again. It was suggested that during the use of immune checkpoint inhibitors, patients with unexplained fever and decreased blood counts, in the absence of improvement in anti-infection, the possibility of hemophagocytic syndrome should be considered and relevant diagnostic tests such as serum ferritin should be improved as soon as possible, and glucocorticoid therapy should be turned on to avoid delay of the disease.

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