TNF and macrophage activation syndrome: Biologics, including tocilizumab (a humanized anti-interleukin-6 receptor monoclonal antibody), rituximab (a chimeric anti-CD20 monoclonal antibody), or adalimumab (a humanized neutralizing anti-tumor necrosis factor monoclonal antibody), were used if the initial therapy failed to control the symptoms of HLH, especially among patients with MAS (Figure 3).