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Home > Vol 40, No 6 (2022) > Wangwarawut

Prognostic Factors of Early Death in Childhood Hemophagocytic Lymphohistiocytosis: Experience From A Single Tertiary Center in Thailand

Kulisara Wangwarawut, Shevachut Chavananon, Natsaruth Songthawee, Pornpun Sripornsawan, Songyos Rajborirug, Thirachit Chotsampancharoen

Abstract

Objective: To establish the clinical profile, outcomes, and risk factors of mortality in pediatric hemophagocytic lymphohistiocytosis (HLH) patients admitted to a tertiary care hospital in the south of Thailand.
Material and Methods: The medical records of HLH patients aged under 15 years were retrospectively reviewed. Survival times were estimated using the Kaplan-Meier estimator. Univariate associations between covariates and survival were visualized with graphs and compared using the log-rank test. Factors with statistical significance in the univariate analysis were included in a multivariate cox regression analysis.
Results: A total of 24 childhood HLH cases were identified over the 20-year study period. Central nervous system (CNS) involvement at diagnosis (hazard ratio [HR]: 7.7, 95% CI: 1.2-51.2), absolute neutrophil count (ANC) <1,000.0 cells/μL (HR: 33.3, 95% CI: 2.7-39.8) and renal insufficiency (HR: 28.2, 95% CI: 2.1-373.8) were adverse risk factors. Forty-six percent of the children survived at least 30 days after diagnosis with a median survival time of 21 days. Conclusion: CNS involvement, low ANC and renal insufficiency at diagnosis were adverse risk factors for early death in HLH children.

 Keywords

hemophagocytic lymphohistiocytosis; prognostic factors; survival outcome

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References

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DOI: http://dx.doi.org/10.31584/jhsmr.2022880

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About The Authors

Kulisara Wangwarawut
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

Shevachut Chavananon
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

Natsaruth Songthawee
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

Pornpun Sripornsawan
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

Songyos Rajborirug
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

Thirachit Chotsampancharoen
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110,
Thailand

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Keywords COVID-19 SARS-CoV-2 Thailand Vietnam anxiety children computed tomography depression diabetes diabetes mellitus elderly knowledge mental health mortality prevalence quality of life reliability risk factors stroke treatment validity
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