Rate of decline of ferritin in patients with hemophagocytic lymphohistiocytosis as a prognostic variable for mortality

Pediatr Blood Cancer. 2011 Jan;56(1):154-5. doi: 10.1002/pbc.22774.


Hemophagocytic lymphohistiocytosis (HLH) is difficult to diagnose and treat. Highly elevated ferritin is strongly associated with HLH and levels may provide a prognostic marker. A comprehensive review of ferritin data from our patients during treatment was analyzed with respect to mortality. A patient was 17 times more likely to die when percent ferritin decrease was less than 50% as compared to a 96% or greater decrease as indicated with multivariate logistic modeling. Higher maximum ferritin levels in the first 3 weeks also contributed to the odds of death (OR = 5.6; 90% CI = 1.2-24.9). Regular ferritin measurements may be useful predicting outcomes in HLH patients.

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Female
  • Ferritins / blood*
  • Humans
  • Infant
  • Lymphohistiocytosis, Hemophagocytic / diagnosis*
  • Lymphohistiocytosis, Hemophagocytic / mortality
  • Male
  • Mortality
  • Odds Ratio
  • Predictive Value of Tests*


  • Biomarkers
  • Ferritins