ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Hematology and Hematological Malignancies
Volume 13 - 2025 | doi: 10.3389/fped.2025.1458490
Prognostic value of blood inflammatory composite markers in the survival of pediatric patients with secondary hemophagocytic lymphohistiocytosis
Provisionally accepted
- Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Objective: This study aimed to explore the prognostic value of blood inflammatory composite markers in the survival of pediatric patients diagnosed with secondary hemophagocytic lymphohistiocytosis (sHLH). Methods: Clinical data from 138 newly diagnosed sHLH patients hospitalized between January 2012 and October 2023 were analyzed. Receiver operating characteristic curve analysis was used to determine cutoff values and evaluate predictive accuracy, while Cox regression analysis was employed to identify prognostic factors. Results: The median age of the 138 sHLH patients was 38 months, with a female-to-male ratio of 0.92. Infection was identified as the most common cause of sHLH, 52.9% testing positive for the epstein-barr virus (EBV). Clinical features included decreased blood cell counts in 87.0% of patients, hypofibrinogenemia in 55.07%, hypertriglyceridemia in 46.38%, and elevated ferritin levels in 94.2%. Additionally, all patients experienced fever, while hepatomegaly and splenomegaly were observed in 66.67% and 76.81%, respectively. During the study, 48 patients died. Cox regression analysis identified red blood cell distribution width (RDW) ≥ 14.35%, fibrinogen < 1.5 g/L, red blood cell distribution width to platelet ratio (RPR) ≥ 0.36, and lactate dehydrogenase to serum albumin ratio (LAR) ≥ 56.02 as significant predictors of decreased survival. Conclusion: This study provides preliminary evidence that accessible inflammatory markers like LAR and RPR may assist in early prognostic assessment of pediatric sHLH. These findings highlight the potential utility of routine blood parameters, warranting further validation in larger, stratified cohorts.
Keywords: hemophagocytic lymphohistiocytosis, prognostic factors, LAR, RPR, Children
Received: 02 Jul 2024; Accepted: 07 Jul 2025.
Copyright: © 2025 Luo, Xie, Chen, Du and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zuochen Du, Affiliated Hospital of Zunyi Medical University, Zunyi, China
Pei Huang, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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