Open AccessFerritin index is a strong prognostic marker in adult hemophagocytic lymphohistiocytosis
Author(s) -
Zhou Jun,
Zhou Jing,
Wu ZhiQi,
Goyal Hemant,
Xu HuaGuo
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13704
Subject(s) - ferritin , medicine , confidence interval , area under the curve , gastroenterology , hemophagocytic lymphohistiocytosis , odds ratio , receiver operating characteristic , survival analysis , disease
Aims The relationship between ferritin levels and survival in adult hemophagocytic lymphohistiocytosis (HLH) has been evaluated in previous studies. However, Admission‐to‐discharge percentage ferritin reduction (named as ferritin index) level in adult patients with HLH has never been evaluated to predict 6‐month survival. Methods The demographic, laboratory and clinical information of 102 newly diagnosed adult HLH patients were collected. Regression analysis, receiver operating curve and Kaplan‐Meier curves were analysed to explore the performance of ferritin levels. Results Ferritin index and discharge ferritin level were significantly different between survivour and non‐survivour group (all P < .001). Ferritin index had the highest area under the curve (AUC) for predicting the survival (AUC = 0.802, P < .001) followed by discharge ferritin (AUC = 0.746, P < .001). Kaplan‐Meier analysis showed a significant difference in survival according to optimum cutoff values of ferritin index ≥ 10.19% ( P < .001) or discharge ferritin ≤ 1056.1 μg/L ( P < .001). Multivariate analysis confirmed that ferritin index and discharge ferritin are independent predictors of 6‐month survival (ferritin index: odds ratio (HR) 6.237, 95% confidence interval (CI) 2.075‐18.774, P = .001; discharge ferritin: HR 6.024, 95% CI 1.894‐19.231, P = .002). In addition, the combination of a ferritin index ≥ 10.19% and discharge ferritin ≤ 1056.1 μg/L had a significantly higher 6‐month survival ( P < .001). Conclusion Ferritin index is a better predictor of 6‐month survival than admission and discharges ferritin levels in adult patients with HLH.