International Journal of Hematology

, Volume 108, Issue 5, pp 485–490 | Cite as

Transfusion requirements and 30-day mortality predictors for adult hemophagocytic lymphohistiocytosis

  • Zaher K. OtrockEmail author
  • Brenda J. Grossman
  • Charles S. Eby
Original Article


Hemophagocytic lymphohistiocytosis (HLH) is a rare clinical syndrome characterized by an uncontrolled hyper-inflammatory response. We assessed the transfusion requirements and predictors of 30-day mortality for adult HLH patients. We identified all adult patients with a diagnosis of HLH at a large academic hospital from October 2003 through February 2017. We extracted patients’ clinical and laboratory data, including transfusion requirements, from their medical records. One-hundred sixteen patients were identified. Their median age was 48 years (range 18–82); 72(62%) were male. Median duration of hospital stay was 19 days (range 1–89 days). At 30 days from admission, 81(70%) patients were alive. Death was attributed to sepsis in 21 patients, lymphoma in six, bleeding in four, GVHD in one, liver failure in one, metastatic solid tumor in one, and unknown in one. Transfusion requirements at 30 days from admission were as follows: RBC, 86% of patients, median 6 units (range 1–58); platelets, 74% of patients, median 6 units (1–67); plasma, 40% of patients, median 4 units (1–56). Renal failure (OR = 4.39; P = 0.008) and hypofibrinogenemia (OR = 4.07; P = 0.009) correlated with 30-day mortality. The transfusion requirements for adult HLH patients were high. Our study indicated that renal insufficiency and hypofibrinogenemia are predictors of early death in adult HLH.


Hemophagocytic lymphohistiocytosis Adult Renal failure Hypofibrinogenemia Transfusion 30-day mortality 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Zaher K. Otrock
    • 1
    Email author
  • Brenda J. Grossman
    • 2
  • Charles S. Eby
    • 2
  1. 1.Department of Pathology and Laboratory MedicineHenry Ford HospitalDetroitUSA
  2. 2.Department of Pathology and ImmunologyBarnes-Jewish Hospital, Washington UniversitySt LouisUSA

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