Cheng Wanying, Wang Lingling, Gao Xin, Duan Limin, Shu Yongqian, Qiu Hongxia
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Front Oncol. 2023 Feb 21;13:1083088. doi: 10.3389/fonc.2023.1083088. eCollection 2023.
Adult secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare clinical syndrome with a high mortality rate. Currently, there are no feasible prognostic factors to clinically predict untreated sHLH patients' prognosis. Our objective was to characterize the lipid profile of adult sHLH patients and to determine the relationship with overall survival.
We retrospectively analyzed 247 patients with newly diagnosed sHLH from January 2017 to January 2022 according to the HLH-2004 criteria. Multivariate Cox regression analyses and restricted cubic splines were conducted to evaluate the prognostic value of the lipid profile.
The median age of all patients was 52 years, and the commonest cause of sHLH in our cohort was malignancy. During a median follow-up of 88 (interquartile ranges, 22-490) days, 154 deaths occurred. The univariate analysis confirmed total cholesterol (TC) ≤ 3 mmol/L, triglycerides (TG) > 3.08 mmol/L, high-density lipoprotein cholesterol (HDL-c) ≤ 0.52 mmol/L, and low-density lipoprotein cholesterol (LDL-c) ≤ 2.17 mmol/L were associated with an inferior survival. In a multivariate model, HDL-c, hemoglobin, platelet, fibrinogen, and soluble interleukin-2 receptor were considered as independent factors. Additionally, the restricted cubic spline analyses indicated an inverse linear association between HDL-c and the risk of mortality in sHLH.
Lipid profiles, which were low-cost and readily available promising biomarkers, were strongly associated with the overall survival in adult sHLH patients.
成人继发性噬血细胞性淋巴组织细胞增生症（sHLH）是一种死亡率很高的罕见临床综合征。目前，尚无可行的预后因素能在临床上预测未经治疗的sHLH患者的预后。我们的目的是描述成人sHLH患者的血脂谱特征，并确定其与总生存期的关系。
我们根据HLH-2004标准，回顾性分析了2017年1月至2022年1月期间247例新诊断的sHLH患者。进行多变量Cox回归分析和限制性立方样条分析以评估血脂谱的预后价值。
所有患者的中位年龄为52岁，我们队列中sHLH最常见的病因是恶性肿瘤。在中位随访88（四分位间距，22 - 490）天期间，发生了154例死亡。单变量分析证实，总胆固醇（TC）≤3 mmol/L、甘油三酯（TG）> 3.08 mmol/L、高密度脂蛋白胆固醇（HDL-c）≤0.52 mmol/L和低密度脂蛋白胆固醇（LDL-c）≤2.17 mmol/L与较差的生存期相关。在多变量模型中，HDL-c、血红蛋白、血小板、纤维蛋白原和可溶性白细胞介素-2受体被视为独立因素。此外，限制性立方样条分析表明，HDL-c与sHLH患者的死亡风险之间存在负线性关联。
血脂谱是低成本且易于获得的有前景的生物标志物，与成人sHLH患者的总生存期密切相关。
