Rate of decline of ferritin in patients with hemophagocytic lymphohistiocytosis as a prognostic variable for mortality.

Pediatr Blood Cancer

Baylor College of Medicine, Department of Pediatrics, Texas Children's Cancer Center/Hematology Service, and Epidemiology Center, Houston, TX, USA.

Published: January 2011

Hemophagocytic lymphohistiocytosis (HLH) is difficult to diagnose and treat. Highly elevated ferritin is strongly associated with HLH and levels may provide a prognostic marker. A comprehensive review of ferritin data from our patients during treatment was analyzed with respect to mortality. A patient was 17 times more likely to die when percent ferritin decrease was less than 50% as compared to a 96% or greater decrease as indicated with multivariate logistic modeling. Higher maximum ferritin levels in the first 3 weeks also contributed to the odds of death (OR = 5.6; 90% CI = 1.2-24.9). Regular ferritin measurements may be useful predicting outcomes in HLH patients.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444147PMC
http://dx.doi.org/10.1002/pbc.22774DOI Listing

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