Analysis of clinical characteristics and prognostic factors of 151 newly diagnosed patients with secondary hemophagocytic lymphohistiocytosis
Objective To investigate the clinical characteristics and related prognostic factors of patients with secondary hemophagocytic lymphohistiocytosis(sHLH).Methods The clinical characteristics and relevant factors influencing the prognosis were retrospectively analyzed in 151 patients with newly diagnosed sHLH.Results The differences in gender distribution,splenomegaly,serum calcium concentration and serum ferritin among the patient groups with different etiologies of sHLH were statistically significant(P＜0.05).The overall survival rates of the 151 sHLH patients newly diagnosed at 1,2 and 3 years were 63.2％,52.2％and 47.5％,respectively.The 1-year survival rates for tumor-associated,infection-associated,autoimmune disease-associated and unknown cause sHLH were 62.1％,51.3％,85.7％and 80.4％,respectively.The results of univariate Cox regression analysis showed that low platelet count,hypofibrinogenemia,low serum calcium concentration and high triglyceride level were the risk factors for death in newly diagnosed sHLH patients(P＜0.05).Multivariate Cox regression analysis showed that low platelet count,hypofibrinogenemia and low serum calcium concentration were the independent risk factors for death in newly diagnosed sHLH patients(P＜0.05).Conclusion Dynamic monitoring of platelet count,fibrinogen level,serum calcium concentration and triglyceride level in the patients with sHLH can help to evaluate the changes of the disease and response to treatment,which is helpful in timely adjusting the treatment.
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