Department of Geriatric Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Department of Hematology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China.
Front Immunol. 2023 May 17;14:1162320. doi: 10.3389/fimmu.2023.1162320. eCollection 2023.
Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare life-threatening systemic disease. This study aimed to assess the prognostic value of pretreatment albumin-bilirubin (ALBI). We retrospectively analyzed 168 non-Hodgkin lymphoma-associated secondary hemophagocytic lymphohistiocytosis (NHL-sHLH) patients with hepatic injuries. Multivariable logistic/Cox models and restricted cubic spline models were conducted to evaluate the relationships between the ALBI score and short- and long-term survival. Among 168 adult NHL-sHLH patients, 82 (48.8%) patients died within 30 days after admission, and 144 (85.7%) patients died during the follow-up period. Multivariable logistic/Cox regression model indicated that ALBI grade could be an independent risk factor for predicting the prognosis of patients with 30-day mortality and overall survival (odds ratios [OR] 5.37, 95% confidence interval 2.41-12.64, < 0.001; hazard ratios [HR] 1.52, 95% confidence interval 1.06-2.18, = 0.023), respectively. The restricted cubic spline curve displayed a linear and positive relationship between the ALBI score and risk of mortality ( for nonlinearity =0.503). Furthermore, receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for predicting mortality by integrative analysis of the ALBI score and ferritin was significantly improved compared to the ALBI score (AUC : 0.820 vs 0.693, = 0.001; AUC: 0.754 vs 0.681, = 0.043) or ferritin (AUC: 0.820 vs 0.724, = 0.005; AUC: 0.754 vs 0.658, = 0.031) alone. The ALBI score could be a useful indicator of short and long-term survival for NHL-sHLH patients with hepatic injuries.
继发性噬血细胞性淋巴组织细胞增生症（sHLH）是一种罕见的危及生命的全身性疾病。本研究旨在评估预处理白蛋白-胆红素（ALBI）的预后价值。我们回顾性分析了 168 例伴有肝损伤的非霍奇金淋巴瘤相关继发性噬血细胞性淋巴组织细胞增生症（NHL-sHLH）患者。采用多变量逻辑/Cox 模型和限制性立方样条模型评估 ALBI 评分与短期和长期生存之间的关系。在 168 例成人 NHL-sHLH 患者中，82 例（48.8%）患者在入院后 30 天内死亡，144 例（85.7%）患者在随访期间死亡。多变量逻辑/Cox 回归模型表明，ALBI 分级可作为预测 30 天死亡率和总生存率的独立危险因素（比值比[OR] 5.37，95%置信区间 2.41-12.64， < 0.001；风险比[HR] 1.52，95%置信区间 1.06-2.18， = 0.023）。限制性立方样条曲线显示 ALBI 评分与死亡率之间存在线性正相关（非线性检验=0.503）。此外，受试者工作特征（ROC）曲线分析表明，ALBI 评分与铁蛋白综合分析预测死亡率的曲线下面积（AUC）明显优于 ALBI 评分（AUC：0.820 与 0.693， = 0.001；AUC：0.754 与 0.681， = 0.043）或铁蛋白（AUC：0.820 与 0.724， = 0.005；AUC：0.754 与 0.658， = 0.031）单独评估。ALBI 评分可作为预测伴有肝损伤的 NHL-sHLH 患者短期和长期生存的有用指标。
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