title: Marrow assessment for hemophagocytic lymphohistiocytosis demonstrates poor correlation with disease probability.
abstract: OBJECTIVE
  To evaluate the amount of hemophagocytosis in 64 marrow core biopsy specimens and aspirates from 58 patients with clinical suspicion for secondary hemophagocytic lymphohistiocytosis (HLH) or reported findings of hemophagocytosis.
  
  
  METHODS
  A review of medical records assigned patients to a low-risk (45 patients) or high-risk (13 patients) HLH group, and association with histologic findings was examined using the Fisher exact test.
  
  
  RESULTS
  The amount of hemophagocytosis in aspirate or the core biopsy specimen did not correlate with disease probability (P = .17 and P = .63, respectively). Of the clinical/laboratory criteria assessed, the most significant correlations with HLH were highly elevated ferritin (P = .01), cytopenias (P = .02), and fever (P = .009).
  
  
  CONCLUSIONS
  Our findings indicated that marrow histologic findings alone do not reliably predict the probability of HLH, and an isolated finding of hemophagocytosis, even when present in a high amount, lacks specificity for HLH.
authors.affiliation: Dept of Pathology, Yale School of Medicine, 310 Cedar St, LH 108, PO Box 208023, New Haven, CT 06520-8023; e-mail: mina.xu@yale.edu.
authors.forename: Caleb
authors.initials: C
authors.lastname: Ho
authors.forename: Xiaopan
authors.initials: X
authors.lastname: Yao
authors.forename: Ligeng
authors.initials: L
authors.lastname: Tian
authors.forename: Fang-Yong
authors.initials: FY
authors.lastname: Li
authors.forename: Nikolai
authors.initials: N
authors.lastname: Podoltsev
authors.forename: Mina L
authors.initials: ML
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D001854:Bone Marrow Cells / Q000276:immunology; D005260:Female; D005293:Ferritins / Q000097:blood; D005334:Fever / Q000150:complications; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D005293:Ferritins
keywords: Bone marrow; Hemophagocytic; Hemophagocytosis; Lymphohistiocytosis