血清钙离子浓度及白蛋白水平在继发性噬血细胞性淋巴组织细胞增多症中的临床意义

OBJECTIVE: To investigate the clinical significance of serum calcium concentrations and albumin levels in patients with secondary hemophagocytic lymphohistiocytosis (sHLH). METHODS: The clinical and laboratory data of 68 patients with newly diagnosed sHLH from April 2013 to April 2016, and 20 healthy controls were retrospectively analyzed. The patients were classified as the clinical remission group and the progression group according to the response criteria. To explore the changes of serum calcium concentrations and albumin levels in the patients, its correlations with other laboratory indexes and the impact on survival. RESULTS: ①The serum calcium concentrations and albumin levels in lymphoma-related HLH group and non-tumor HLH group were lower than control group (P<0.05); The serum calcium concentrations and albumin levels in the clinical remission group after treatment was higher than that before treatment (P<0.01), while in the progression group the serum calcium concentrations after treatment decreased (P=0.002), the albumin levels did not changed significantly (P=0.086). ②The serum calcium concentrations in newly diagnosed sHLH patients was positively correlated with ANC, PLT, HGB (P<0.05), and negatively with ferritin (P<0.05); The overall survival (OS) was significantly longer in patients with serum calcium concentration≥1.92 mmol/L than that<1.92 mmol/L (266 d vs 95 d, P=0.006). ③The serum albumin levels in newly diagnosed sHLH patients was positively correlated with ANC, HGB (P<0.05), and negatively with ferritin (P<0.05); The overall survival was longer in patients with serum albumin level ≥ 26.7 g/L than that<26.7 g/L (263 d vs 95 d, P=0.023). ④The serum calcium concentrations in patients before treatment was positively correlated with serum albumin levels (P<0.001), and no significant correlation was found in control group (P=0.079). CONCLUSION: The serum calcium concentrations and albumin levels have clinical significance for disease diagnosis, decision-making therapy and treatment outcomes in the patients with sHLH.