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Prognostic factors of hemophagocytic syndrome in adults: analysis of 34 cases
Author(s) -
Kaito K.,
Kobayashi M.,
Katayama T.,
Otsubo H.,
Ogasawara Y.,
Sekita T.,
Saeki A.,
Sakamoto M.,
Nishiwaki K.,
Masuoka H.,
Shimada T.,
Yoshida M.,
Hosoya T.
Publication year - 1997
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1997.tb00984.x
Subject(s) - medicine , pancytopenia , disseminated intravascular coagulation , gastroenterology , anemia , jaundice , elevated transaminases , histiocytosis , hemophagocytosis , malignant histiocytosis , disease , histiocyte , immunology , bone marrow
Hemophagocytic syndrome (HPS) presents with fever, pancytopenia, liver dysfunction and increase in hemophagocytic histiocytes in various organs. Although there are two major classifications of HPS in adults, malignant and reactive histiocytosis, it is often very difficult to distinguish between these disorders. We analyzed the laboratory data of patients with HPS to evaluate prognostic factors. Of 34 patients, 14 survived, and 20 died. The median age of survivors was 29.6 ± 11.5 yr significantly younger than those who died (54.7 ± 17.8 yr). Twenty patients had no obvious underlying disease, the other 13 had hematological malignancies or viral infections. Comparison of laboratory data revealed that nonsurvivors had significantly lower Hb and platelet values on admission. During treatment, worsening of anemia and thrombocytopenia, increase of transaminase and biliary enzymes were similarly more prominent. Risk factors associated with death were: age over 30 yr, presence of disseminated intravascular coagulation, increased ferritin and β 2 ‐microglobulin, anemia accompanied by thrombocytopenia and jaundice. Our data suggests that patients with HPS and any of these risk factors should be treated aggressively with sufficient chemotherapy and supportive care.