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**anti-CD41-PLT-etoposide** is an experimental macrophage-targeted engineered platelet therapy for hemophagocytic lymphohistiocytosis. It consists of platelets sensitized with an anti-CD41 antibody and loaded with etoposide, also called VP16. The anti-CD41-coated platelet carrier is designed to be preferentially phagocytosed by hyperactivated macrophages, concentrating etoposide in pathogenic macrophages. Intracellular etoposide inhibits DNA topoisomerase II, promotes macrophage apoptosis, suppresses hemophagocytosis and cytokine-storm biology, and indirectly reduces aberrant T-cell and natural-killer-cell activation. Preclinical HLH-model data and an early single-arm clinical study have been reported. ([advanced.onlinelibrary.wiley.com](https://advanced.onlinelibrary.wiley.com/doi/pdf/10.1002/advs.202404571))
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