Marrow Assessment for Hemophagocytic Lymphohistiocytosis Demonstrates Poor Correlation With Disease Probability
Marrow Assessment for Hemophagocytic Lymphohistiocytosis Demonstrates Poor Correlation With Disease Probability
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DOI：
10.1309/ajcpmd5tjefoovbw
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发表时间：
2014-01-01
影响因子：
3.5
通讯作者：
Xu, Mina L.
中科院分区：
文献类型：
--
作者：
Ho, Caleb;Yao, Xiaopan;Xu, Mina L.
目的：对58例临床怀疑继发性噬血细胞性淋巴组织细胞增生症或有噬血细胞增生症的患者的骨髓活检标本和抽吸物中的吞血量进行评估。方法：回顾病例资料，将患者分为低危组(45例)和高危组(13例)，并与组织学结果进行FISHER精确检验。结果：抽吸物和核心活检标本中的吞血量与发病概率无关(P=0.17和P=0.63)。在评估的临床/实验室标准中，与HLH最显著的相关性是铁蛋白高度升高(P=0.01)、细胞减少(P=0.02)和发热(P=0.009)。结论：我们的研究结果表明，仅凭骨髓组织学结果并不能可靠地预测发生HLH的可能性，而且孤立的吞噬血细胞的发现，即使出现数量很高，也缺乏HLH的特异性。
Objectives: 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.