Histocytosis Flashcards
What level of ferritin is considered 90% sensitive and 96% specific for HLH?
10000
The exceptions are obvious clinically in that patients with post-stem cell transplant mucositis have ferritin levels up to 46,700, and chronically transfused patients with poor chelation therapy may be in the 10,000 to 20,000 range.
Which HLH criterion cited is most variable or least helpful?
A review of several studies of patients with hemophagocytic lymphohistiocytosis reporting on the percentage of patients with hemophagocytosis in the marrow showed a range of 20% to 100%, with most being around 50%.
This variability is likely due to the varying tempo of the disease or perhaps the different etiologies (infectious versus genetic).
High risk LCH organs
The “high-risk” organs are liver, spleen, and bone marrow.
In the LCH-III study, mortality was 12%, but more than 40% needed additional treatments beyond Vinblastine and prednisone.
