title: Hemophagocytic Lymphohistiocytosis and Bone Marrow Hemophagocytosis: A 5-Year Institutional Experience at a Tertiary Care Hospital.
abstract: The purpose of this study was to correlate the significance of bone marrow hemophagocytosis and analyze outcome data in patients with suspected hemophagocytic lymphohistiocytosis (HLH) at a tertiary care hospital during the course of 5 years.
  
  
  
  The pathology database of State University of New York Upstate Medical University, Syracuse, was searched for the terms "hemophagocytosis," "hemophagocytic syndrome," and "hemophagocytic lymphohistiocytosis" encompassing the period January 2009-December 2014. Bone marrow aspirate and biopsy specimens, along with ancillary laboratory studies, clinical course, and outcome data, were reviewed for each case.
  
  
  
  Of the 23 patients included in our study, HLH was diagnosed in 14 (60.8%). Bone marrow hemophagocytosis (HPC) was seen in a higher proportion of patients (78.5%) who were diagnosed as having HLH; however, 55.5% of the patients who were not diagnosed as having HLH also showed evidence of bone marrow HPC. Patients with malignancy-associated HLH had a markedly worse outcome compared with patients with nonmalignancy-associated HLH.
  
  
  
  Although bone marrow HPC is fairly sensitive, it is not specific to establish a diagnosis of HLH. A high index of clinical suspicion together with early diagnosis and treatment is imperative to improve outcomes in patients suspected of having HLH.
authors.affiliation: From the Departments of Pathology and Internal Medicine, State University of New York Upstate Medical University, Syracuse.
authors.forename: Kriselle
authors.initials: K
authors.lastname: Lao
authors.affiliation: From the Departments of Pathology and Internal Medicine, State University of New York Upstate Medical University, Syracuse.
authors.forename: Namita
authors.initials: N
authors.lastname: Sharma
authors.affiliation: From the Departments of Pathology and Internal Medicine, State University of New York Upstate Medical University, Syracuse.
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gajra
authors.affiliation: From the Departments of Pathology and Internal Medicine, State University of New York Upstate Medical University, Syracuse.
authors.forename: Neerja
authors.initials: N
authors.lastname: Vajpayee
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010587:Phagocytosis; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents