Introduction: Liver dysfunction is common in patients with hemophagocytic lymphohistiocytosis (HLH). However, whether the severity of liver injury is associated with the prognosis of patients with HLH remains to be determined. This study aims to assess the association of the severity of liver involvement with short-term prognosis among adult patients with HLH. Methods: A retrospective study was performed from January 2012 to December 2020, including 150 patients with newly diagnosed HLH and liver injury. Results: The majority of our cohort suffered from mild to moderate hepatic damage, presenting with Child-Turcotte-Pugh (CTP) class A (55, 36.7%) or B (74, 49.3%). The prevalence of acute liver failure (ALF) was 9.3% in our cohort. The overall 30-day mortality rate was 49.3% among the study population. HLH patients with ALF showed an extremely adverse prognosis, with a mortality rate as high as 92.9%. In a multivariate analysis, age >= 60 years (p = 0.016), blood urea nitrogen (BUN) >= 7 mu mol/L (p < 0.001), and malignancy-associated HLH (p < 0.001) at the diagnosis of HLH were identified as being strongly correlated with 30-day prognosis. An excellent predictive power was found. Among the predictive scores used to assess early death of HLH patients with liver injury, the prognostic efficiency of chronic liver failure-sequential organ failure assessment (CLIF-SOFA) (AUROC: 0.936 +/- 0.0211) and SOFA score (0.901 +/- 0.026) were significantly better than those of the APACHE II (p < 0.001), model for end-stage liver disease score (p < 0.001) and CTP scores (p < 0.001). Conclusion: Patients with old age, elevated BUN, and malignancy had inferior survival. CLIF-SOFA and SOFA enable more accurate prediction of early death in HLH patients with liver injury than other liver-specific and general prognostic models.
[12]
Liver Failure and Artificial Liver Group Chinese Society of Infectious Diseases Chinese Medical Association, 2019, Zhonghua Gan Zang Bing Za Zhi, V27, P18, DOI 10.3760/cma.j.issn.1007-3418.2019.01.006
机构:
Kaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Schneier, Amanda
Stueck, Ashley E.
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机构:
Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Stueck, Ashley E.
Petersen, Bruce
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Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Petersen, Bruce
Thung, Swan N.
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Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Thung, Swan N.
Perumalswami, Ponni
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Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
机构:
Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Schram, Alison M.
Comstock, Paige
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Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Comstock, Paige
Campo, Meghan
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Beth Israel Deaconess Med Ctr, Dept Med, Div Hematol, Boston, MA 02215 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Campo, Meghan
Gorovets, Daniel
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NYU, Sch Med, Dept Radiat Oncol, New York, NY USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Gorovets, Daniel
Mullally, Ann
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Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Hematol,Dept Med, Boston, MA 02115 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Mullally, Ann
Bodio, Kelly
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h-index: 0
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Vernon Canc Ctr, New England Hematol Oncol Associates, Div Hematol Oncol, Newton, MA USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Bodio, Kelly
Arnason, Jon
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Beth Israel Deaconess Med Ctr, Dept Med, Div Hematol, Boston, MA 02215 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Arnason, Jon
Berliner, Nancy
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Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Hematol,Dept Med, Boston, MA 02115 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
[12]
Liver Failure and Artificial Liver Group Chinese Society of Infectious Diseases Chinese Medical Association, 2019, Zhonghua Gan Zang Bing Za Zhi, V27, P18, DOI 10.3760/cma.j.issn.1007-3418.2019.01.006
机构:
Kaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Schneier, Amanda
Stueck, Ashley E.
论文数: 0引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Stueck, Ashley E.
Petersen, Bruce
论文数: 0引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Petersen, Bruce
Thung, Swan N.
论文数: 0引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
Thung, Swan N.
Perumalswami, Ponni
论文数: 0引用数: 0
h-index: 0
机构:
Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10029 USAKaiser Permanente Panorama City Med Ctr, Hosp Med, Panorama City, CA 91402 USA
机构:
Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Schram, Alison M.
Comstock, Paige
论文数: 0引用数: 0
h-index: 0
机构:
Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Comstock, Paige
Campo, Meghan
论文数: 0引用数: 0
h-index: 0
机构:
Beth Israel Deaconess Med Ctr, Dept Med, Div Hematol, Boston, MA 02215 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Campo, Meghan
Gorovets, Daniel
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Sch Med, Dept Radiat Oncol, New York, NY USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Gorovets, Daniel
Mullally, Ann
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Hematol,Dept Med, Boston, MA 02115 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Mullally, Ann
Bodio, Kelly
论文数: 0引用数: 0
h-index: 0
机构:
Vernon Canc Ctr, New England Hematol Oncol Associates, Div Hematol Oncol, Newton, MA USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Bodio, Kelly
Arnason, Jon
论文数: 0引用数: 0
h-index: 0
机构:
Beth Israel Deaconess Med Ctr, Dept Med, Div Hematol, Boston, MA 02215 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA
Arnason, Jon
Berliner, Nancy
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Hematol,Dept Med, Boston, MA 02115 USAHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA