title: Diagnostic value of serum ferritin and the risk factors and cytokine profiles of hemophagocytic syndrome following allogeneic hematopoietic cell transplantation.
abstract: To examine the diagnostic value of serum ferritin, the associated risk factors, and cytokine profiles of hemophagocytic syndrome (HPS) following allogeneic hematopoietic cell transplantation (allo-HCT), we retrospectively analyzed data from patients undergoing allo-HCT between 2006 and 2012. Of 223 eligible patients, 18 patients developed HPS. A serum ferritin level above 30,000 μg/l was highly specific for the detection of HPS (specificity, 93%). The one-year survival rate for HPS was significantly lower than that of non-HPS patients (37.5% vs. 72.9%, respectively, Log-rank p < .01). In multivariable Cox models, antigen mismatches in human leukocyte antigen (HLA) in both graft-versus-host (GVH) and host-versus-graft (HVG) directions were significantly associated with the incidence of HPS. We found a significant elevation of Th1 cytokine (IFN-γ), Th2 cytokines (IL-10), and chemokines (MCP-1 and IP-10), at the onset of HPS. Our results suggest that allo-reactivity, derived from HLA-mismatch, and possibly causing a cytokine storm, may be associated with HPS development.
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Nanno
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Koh
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Katayama
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okamura
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Koh
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Yoshimura
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Nishimoto
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Nakamae
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Asao
authors.initials: A
authors.lastname: Hirose
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakane
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hino
authors.affiliation: a Hematology, Graduate School of Medicine , Osaka City University , Osaka , Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Nakamae
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D016207:Cytokines / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D006680:HLA Antigens; D005293:Ferritins
keywords: Hemophagocytic syndrome; allogeneic hematopoietic cell transplantation; risk factor; serum cytokine profile; serum ferritin