title: Prognostic factors of hemophagocytic syndrome in adults: analysis of 34 cases.
abstract: 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 beta2-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.
authors.affiliation: Department of Central Laboratories, Kashiwa Hospital, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kaito
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Katayama
authors.forename: H
authors.initials: H
authors.lastname: Otsubo
authors.forename: Y
authors.initials: Y
authors.lastname: Ogasawara
authors.forename: T
authors.initials: T
authors.lastname: Sekita
authors.forename: A
authors.initials: A
authors.lastname: Saeki
authors.forename: M
authors.initials: M
authors.lastname: Sakamoto
authors.forename: K
authors.initials: K
authors.lastname: Nishiwaki
authors.forename: H
authors.initials: H
authors.lastname: Masuoka
authors.forename: T
authors.initials: T
authors.lastname: Shimada
authors.forename: M
authors.initials: M
authors.lastname: Yoshida
authors.forename: T
authors.initials: T
authors.lastname: Hosoya
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015620:Histiocytic Disorders, Malignant / Q000401:mortality / Q000503:physiopathology*; D015616:Histiocytosis, Non-Langerhans-Cell / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors