Correlation Analysis of Inflammatory Indexes and Bone Marrow Cytological Characteristics with Prognosis in Patients with Hemophagocytic Lymphohistiocytosis.
10.19746/j.cnki.issn.1009-2137.2025.04.023
- Author:
Guo-Xiang CHEN
1
;
Jian-Shu HAO
2
;
Qing-Qing ZHANG
1
;
Hai-Xia AN
1
;
Yan-Qing SUN
3
;
Xiu-Juan HUANG
3
Author Information
1. The First Clinical Medical School of Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province.
2. Department of Vascular Surgery, The First People's Hospital of Yinchuan, Yinchuan 750000, Ningxia Hui Autonomous Region.
3. Department of Hematology, Gansu Provincial People's Hospital, Lanzhou 730000，Gansu Province, China.
- Publication Type:Journal Article
- Keywords:
hemophagocytic lymphohistiocytosis;
inflammatory indexes;
bone marrow cellularity;
clinical features;
prognosis
- MeSH:
Humans;
Lymphohistiocytosis, Hemophagocytic/diagnosis*;
Prognosis;
Female;
Male;
Middle Aged;
Adult;
Aged;
Adolescent;
Child;
Child, Preschool;
Infant;
Young Adult;
Bone Marrow/pathology*;
Aged, 80 and over;
Inflammation
- From:
Journal of Experimental Hematology
2025;33(4):1086-1093
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the clinical characteristics and prognosis of patients with hemophagocytic lymphohistiocytosis (HLH).
METHODS:Clinical data of 78 patients with HLH admitted to Gansu Provincial People's Hospital from January 2014 to May 2023 were collected, and the correlation between relevant indicators and patient prognosis was analyzed.
RESULTS:Among the 78 HLH patients, there were 48 males and 30 females, with a median age of onset of 48 (1-84) years old; 26 patients were treated with chemotherapy, 44 patients were treated with glucocorticoids, immunoglobulin or cyclosporine, 5 patients received symptomatic treatment, 1 patient received plasma exchange, and 2 patients refused treatment. By the end of the follow-up, there were 39 survivors, 35 deaths, and 4 patients lost to follow-up. There was no significant correlation between sex, ferritin, triglycerides, hemophagocytosis, bone marrow cellularity, Epstein-Barr virus (EBV) infection, SUV value of PET-CT, alanine aminotransferase (ALT), interleukin-6 (IL-6), platelet-to-lymphocyte ratio (PLR) and overall survival (OS) of the patients (P >0.05). Patients with age≥60 years, neutrophil-to-lymphocyte ratio (NLR) >0.59, red cell distribution width-to-platelet ratio (RPR) >0.30, lymphocyte-to-monocyte ratio (LMR)≤2.74, red blood cell distribution width (RDW)>16.45%, tumor-associated HLH, aspartate aminotransferase (AST)≥148 U/L, procalcitonin (PCT)≥0.66 ng/ml, neutrophils (NEU) <2×109/L, fibrinogen (FIB)<1.85 g/L, lactate dehydrogenase (LDH)≥1 740 U/L, hemoglobin (Hb)<85 g/L, platelet (PLT)<57×109/L had significantly shorter OS, with statistical significance (P < 0.05). Multivariate analysis showed that LMR≤2.74, RDW>16.45%, LDH≥1 740 U/L, and NEU<2×109/L were independent risk factors affecting OS in HLH patients (P < 0.05).
CONCLUSION:Some blood-based inflammatory markers are significantly associated with OS in patients with HLH. NLR, RPR, LMR, RDW and PCT can be used to assess the prognosis of HLH patients, and RDW and LMR are independent factors affecting OS of HLH patients, which provide greater predictive value for prognosis. Hypercellular bone marrow in HLH patients may indicate a poor prognosis.
