Diagnostic value of serum ferritin and the risk factors and cytokine profiles of hemophagocytic syndrome following allogeneic hematopoietic cell transplantation. Issue 7 (3rd July 2017)

• Record Type: Journal Article
• Authors: Nanno, Satoru; Koh, Hideo; Nakashima, Yasuhiro; Katayama, Takako; Okamura, Hiroshi; Koh, Shiro; Yoshimura, Takuro; Nishimoto, Mitsutaka; Hayashi, Yoshiki; Nakamae, Mika; Hirose, Asao; Nakane, Takahiko; Hino, Masayuki; Nakamae, Hirohisa
• Is Part Of: Leukemia & lymphoma. Volume 58:Issue 7(2017)
• Page Start: 1664
• Page End: 1672
• Publication Date: 2017-07-03
• Subjects: Hemophagocytic syndrome -- allogeneic hematopoietic cell transplantation -- serum ferritin -- risk factor -- serum cytokine profile; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2016.1262034
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: To examine the diagnostic value of serum ferritin, the associated risk factors, and cytokine profiles of hemophagocytic syndrome (HPS) following allogeneic hematopoietic cell transplantation (allo-HCT), we retrospectively analyzed data from patients undergoing allo-HCT between 2006 and 2012. Of 223 eligible patients, 18 patients developed HPS. A serum ferritin level above 30, 000 μg/l was highly specific for the detection of HPS (specificity, 93%). The one-year survival rate for HPS was significantly lower than that of non-HPS patients (37.5% vs. 72.9%, respectively, Log-rank p < .01). In multivariable Cox models, antigen mismatches in human leukocyte antigen (HLA) in both graft-versus-host (GVH) and host-versus-graft (HVG) directions were significantly associated with the incidence of HPS. We found a significant elevation of Th1 cytokine (IFN-γ), Th2 cytokines (IL-10), and chemokines (MCP-1 and IP-10), at the onset of HPS. Our results suggest that allo-reactivity, derived from HLA-mismatch, and possibly causing a cytokine storm, may be associated with HPS development.