A high sIL-2R/ferritin ratio is a useful marker for the diagnosis of lymphoma-associated hemophagocytic syndrome.
Lymphoma-associated hemophagocytic syndrome (LAHS), which is the major subtype of adult-onset secondary hemophagocytic lymphohistiocytosis (HLH), has a poor outcome. Although the early diagnosis and treatment of LAHS contributes to a better outcome, the lack of mass formation and the absence of distinct lymph node enlargement often delay the diagnosis of underlying lymphoma. A recent study, which statistically analyzed HLH cases in the literature, showed that the serum soluble interleukin-2 receptor (sIL-2R)/ferritin ratio could be used as a marker to diagnosis of LAHS. To verify this finding, we retrospectively analyzed the laboratory findings of 21 patients with HLH (10 benign disease-associated HLH and 11 LAHS). No significant differences were observed in the levels of LDH or CRP levels. The mean sIL-2R levels (units per milliliter) were significantly higher in the LAHS group (4,176 vs. 13,451, p = 0.0031), and ferritin levels (nanogram per milliliter) were higher in the benign disease-associated HLH group (20,462 vs. 2,561, p = 0.0031). Consequently, the mean serum sIL-2R/ferritin ratio of patients with LAHS was markedly higher than that of patients with benign disease-associated HLH (0.66 vs. 8.56, p = 0.0004). Thus, the results of this study demonstrated that the serum sIL-2R/ferritin ratio is a very useful marker for diagnosing of LAHS, which was further supported by clinical case analysis. Further studies to clarify the pathophysiology of secondary HLH caused by various triggers are needed.
Division of Hematology and Oncology, Kumamoto City Hospital, Kotoh 1-1-60, Kumamoto, 862-8505, Japan, tsuji.takahiro@city.kumamoto.lg.jp.
Takahiro
T
Tsuji
Taichi
T
Hirano
Hiroshi
H
Yamasaki
Mayumi
M
Tsuji
Hiroyuki
H
Tsuda
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics; D002097:C-Reactive Protein / Q000235:genetics / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood* / Q000235:genetics; D015870:Gene Expression; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood / Q000235:genetics; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000235:genetics; D008223:Lymphoma / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000235:genetics; D008297:Male; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000097:blood* / Q000235:genetics; D012189:Retrospective Studies; D012995:Solubility
D014408:Biomarkers, Tumor; D015375:Receptors, Interleukin-2; D002097:C-Reactive Protein; D005293:Ferritins; D007770:L-Lactate Dehydrogenase