title: Rate of decline of ferritin in patients with hemophagocytic lymphohistiocytosis as a prognostic variable for mortality.
abstract: Hemophagocytic lymphohistiocytosis (HLH) is difficult to diagnose and treat. Highly elevated ferritin is strongly associated with HLH and levels may provide a prognostic marker. A comprehensive review of ferritin data from our patients during treatment was analyzed with respect to mortality. A patient was 17 times more likely to die when percent ferritin decrease was less than 50% as compared to a 96% or greater decrease as indicated with multivariate logistic modeling. Higher maximum ferritin levels in the first 3 weeks also contributed to the odds of death (OR = 5.6; 90% CI = 1.2-24.9). Regular ferritin measurements may be useful predicting outcomes in HLH patients.
authors.affiliation: Baylor College of Medicine, Department of Pediatrics, Texas Children's Cancer Center/Hematology Service, and Epidemiology Center, Houston, TX, USA.
authors.forename: Tiffany F
authors.initials: TF
authors.lastname: Lin
authors.forename: Laura L
authors.initials: LL
authors.lastname: Ferlic-Stark
authors.forename: Carl E
authors.initials: CE
authors.lastname: Allen
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Kozinetz
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: McClain
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007223:Infant; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D009026:Mortality; D016017:Odds Ratio; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D005293:Ferritins