Clinicopathological characteristics, prognostic factors, and outcomes of elderly patients with lymphoma-associated hemophagocytic lymphohistiocytosis: A multicenter analysis

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-09-01 DOI:10.1002/cam4.70178

Yi Miao, Jing Zhang, Xuzhang Lu, Meng Wu, Bingzong Li, Liang Yu, Miao Sun, Yun Zhuang, Yuqing Miao, Haiwen Ni, Xiaoyan Xie, Jingyan Xu, Yunping Zhang, Min Zhao, Min Xu, Wanchuan Zhuang, Weiying Gu, Guoqiang Lin, Haiying Hua, Jianfeng Zhu, Maozhong Xu, Tao Jia, Ping Liu, Lijia Zhai, Tongtong Zhang, Qiurong Shan, Qiudan Shen, Jun Qian, Chunling Wang, Jianyong Li, Wenyu Shi

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Abstract

Background

Lymphoma is the most common secondary cause of hemophagocytic lymphohistiocytosis (HLH) in adults. Lymphoma-associated HLH (LA-HLH) in the elderly population is not rare, however, little has been reported regarding clinicopathological characteristics, prognostic factors, and outcomes of LA-HLH in the elderly population.

Methods

We retrospectively analyzed a multicenter cohort of elderly patients with LA-HLH. Clinicopathological features and treatment information were collected. The impacts of baseline characteristics and treatments on survival outcomes were analyzed.

Results

A total of 173 elderly patients with LA-HLH were included. Compared with young patients, elderly patients showed different clinical and laboratory features. Regarding lymphoma subtypes, B-cell lymphoma was more common in elderly patients (elderly 61.3% vs. young 32.3%, p < 0.001) while T/NK-cell lymphoma was more common in young patients (65.3% vs. 35.3%, p < 0.001). The median survival of elderly patients with LA-HLH was only 92 days. The prior use of HLH therapy or etoposide-containing HLH therapy was not associated with improved overall survival. T/NK-cell subtype, a lower platelet count (≤53 × 10⁹/L), a lower albumin level (≤32.1 g/L), a higher LDH level (>1407 U/L), and a higher creatinine level (>96.8 μmol/L) were independent predictors of decreased overall survival and 60-day survival. A prognostic index was established and demonstrated to be robust in predicting the overall survival and 60-day survival of elderly patients with LA-HLH.

Conclusions

LA-HLH in elderly patients displayed heterogeneous clinicopathological features and survival outcomes. Treatments need to be optimized to improve the outcomes of elderly patients with LA-HLH.

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淋巴瘤相关性嗜血细胞淋巴组织细胞增多症老年患者的临床病理特征、预后因素和预后：多中心分析

背景：淋巴瘤是成人嗜血细胞淋巴组织细胞增多症（HLH）最常见的继发性病因。淋巴瘤相关性 HLH（LA-HLH）在老年人群中并不罕见，但有关老年人群中 LA-HLH 的临床病理特征、预后因素和预后的报道却很少：方法：我们对一个多中心队列中的 LA-HLH 老年患者进行了回顾性分析。收集了临床病理特征和治疗信息。分析基线特征和治疗方法对生存结果的影响：结果：共纳入173例LA-HLH老年患者。与年轻患者相比，老年患者表现出不同的临床和实验室特征。在淋巴瘤亚型方面，B细胞淋巴瘤在老年患者中更为常见（老年61.3%对年轻32.3%，P 9/L），白蛋白水平较低（≤32.1 g/L）、LDH水平较高（>1407 U/L）和肌酐水平较高（>96.8 μmol/L）是总生存率和60天生存率下降的独立预测因素。结论：建立了一个预后指数，并证明该指数能准确预测老年 LA-HLH 患者的总生存率和 60 天生存率：结论：老年LA-HLH患者的临床病理特征和生存结果各不相同。结论：老年LA-HLH患者的临床病理特征和生存结果具有异质性，需要优化治疗以改善老年LA-HLH患者的预后。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.