Department of Hematology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, China.
Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
Ann Hematol. 2024 Apr;103(4):1159-1166. doi: 10.1007/s00277-024-05663-6. Epub 2024 Feb 20.
We aimed to examine the association between baseline platelet count (PLT) and the prognosis of adult secondary hemophagocytic lymphohistiocytosis (sHLH). Data from 292 patients with pretreatment platelet counts were retrospectively analysed from January 2016 to December 2020. We categorized platelet count into quartiles. Multivariable Cox proportional hazards models and restricted cubic splines (RCS) were used to evaluate the relationship between platelet count and mortality. During a median follow-up of 53 (interquartile ranges, 17-223) days, a total of 208 deaths occurred. After adjusting for multiple variables, a non-linear and inverse relationship was observed between platelet count and mortality in sHLH patient (P for nonlinearity=0.002). For non- lymphoma-associated haemophagocytic lymphohistiocytosis (non-LHLH), a similar curve was also observed (P for nonlinearity =0.028). Decreased PLT (PLT Q4) was associated with an increased risk of mortality (adjusted hazard ratio: 1.97; 95% confidence interval: 1.28-3.04; P =0.005). Similar results were observed in the LHLH subgroup (adjusted hazard ratio: 1.84; 95% confidence interval: 1.05-3.24; P =0.024) but not in the non-LHLH subgroup (P =0.266). Baseline platelet count demonstrated a nonlinear and inverse association with an increased risk of mortality among adult sHLH patients. This method is used to identify sHLH patients with inferior overall survival due to its low cost and universal availability.
我们旨在研究基线血小板计数（PLT）与成人继发性噬血细胞性淋巴组织细胞增生症（sHLH）预后之间的关系。回顾性分析了 2016 年 1 月至 2020 年 12 月接受治疗前血小板计数的 292 例患者的数据。我们将血小板计数分为四分位。多变量 Cox 比例风险模型和限制性立方样条（RCS）用于评估血小板计数与死亡率之间的关系。在中位数为 53（四分位间距，17-223）天的随访期间，共有 208 例死亡。在调整了多个变量后，sHLH 患者的血小板计数与死亡率之间呈非线性和反向关系（非线性 P=0.002）。对于非淋巴瘤相关性噬血细胞性淋巴组织细胞增生症（非-LHLH），也观察到类似的曲线（非线性 P=0.028）。血小板计数降低（PLT Q4）与死亡率增加相关（调整后的危险比：1.97；95%置信区间：1.28-3.04；P=0.005）。在 LHLH 亚组中观察到了类似的结果（调整后的危险比：1.84；95%置信区间：1.05-3.24；P=0.024），但在非-LHLH 亚组中未观察到（P=0.266）。基线血小板计数与成人 sHLH 患者死亡率增加呈非线性和反向关系。这种方法用于识别由于成本低和普遍可用性而总体生存较差的 sHLH 患者。
