[Prognostic Value of Serum Total Bilirubin in Lymphoma-Associated Hemophagocytic Lymphohistiocytosis].

OBJECTIVE

To evaluate the prognostic significance of serum total bilirubin (TBIL) in lymphoma-associated hemophagocytic lymphohistiocytosis (LA-HLH).

METHODS

The clinical data of 251 adult patients with LA-HLH admitted to the First Affiliated Hospital of Nanjing Medical University from January 2011 to April 2024 were retrospectively analyzed. According to the serum TBIL levels, the patients were stratified into a TBIL-normal group and a TBIL-elevated group. The differences in clinical parameters, 60-day survival rate, and median overall survival (OS) were compared between the two groups.

RESULTS

Compared to patients with normal TBIL, those with elevated TBIL had significantly higher levels of soluble CD25 (sCD25), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), along with lower levels of platelets (PLT) and fibrinogen (FIB) (all P<0.05). Among patients with T/NK-cell non-Hodgkin lymphoma (T/NK-NHL)-associated HLH, those with elevated serum TBIL had a lower 60-day survival rate and a shorter median OS (both P<0.05).

CONCLUSION

In patients with LA-HLH, elevated serum TBIL is associated with decreased PLT and FIB levels, as well as increased levels of sCD25, AST and ALT. For patients with HLH secondary to T/NK-NHL, elevated serum TBIL indicates a poor prognosis.