title: Plasma Levels of Presepsin (Soluble CD14-subtype) as a Novel Prognostic Marker for Hemophagocytic Syndrome in Hematological Malignancies.
abstract: Objective Recent studies suggest that presepsin (soluble CD14-subtype) is a useful diagnostic and prognostic marker for sepsis, with secretion by activated macrophages potentially dependent on phagocytosis of microorganisms. As "hemophagocytosis" is one of the major characteristics in patients with hemophagocytic syndrome (HPS), we hypothesized that presepsin may reflect the phagocytic activity and be a useful prognostic marker for HPS. Therefore, we aimed to assess the prognostic potential of presepsin in secondary HPS in adult patients with hematological malignancies. Methods Between April 2006 and August 2014, we retrospectively examined consecutive patients with HPS whose blood samples were available at our institution and compared the prognostic value of the following in HPS, singly and in combination: plasma presepsin, serum soluble interleukin (IL)-2 receptor (sIL-2R), ferritin, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), IL-6 and IL-10. Results A total of 14 patients were enrolled. The median age of the patients was 46.5 years (range, 22-65). In univariable Cox models, there were no significant variables associated with the prognosis. However, in 12 evaluable patients, only the combination of higher median values of presepsin (>1,935 pg/mL) and sIL-2R (>4,585 U/mL) at the onset of HPS was significantly associated with the 90-day mortality (hazard ratio 14.5; 95% CI, 1.47-143.36; p=0.02). Conclusion These results suggest that a composite model of plasma presepsin and serum sIL-2R levels at the onset of HPS might be a novel predictor of the prognosis of patients with hematological malignancies and secondary HPS.
authors: Hematology, Graduate School of Medicine, Osaka City University, Japan.
authors: Satoru
authors: S
authors: Nanno
authors: Hideo
authors: H
authors: Koh
authors: Takako
authors: T
authors: Katayama
authors: Masamichi
authors: M
authors: Hashiba
authors: Ayumi
authors: A
authors: Sato
authors: Yosuke
authors: Y
authors: Makuuchi
authors: Joji
authors: J
authors: Nagasaki
authors: Masatomo
authors: M
authors: Kuno
authors: Takuro
authors: T
authors: Yoshimura
authors: Hiroshi
authors: H
authors: Okamura
authors: Mitsutaka
authors: M
authors: Nishimoto
authors: Asao
authors: A
authors: Hirose
authors: Mika
authors: M
authors: Nakamae
authors: Takahiko
authors: T
authors: Nakane
authors: Masayuki
authors: M
authors: Hino
authors: Hirohisa
authors: H
authors: Nakamae
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D005260:Female; D005293:Ferritins / Q000097:blood; D019337:Hematologic Neoplasms / Q000097:blood*; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000097:blood; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; C508609:IL10 protein, human; D015850:Interleukin-6; D018950:Lipopolysaccharide Receptors; D010446:Peptide Fragments; D015375:Receptors, Interleukin-2; D014409:Tumor Necrosis Factor-alpha; C000594167:presepsin protein, human; D016753:Interleukin-10; D007371:Interferon-gamma; D005293:Ferritins