Increased levels of serum interleukin-10 are associated with poor outcome in adult hemophagocytic lymphohistiocytosis patients

Abstract

Background Interleukin-10 (IL-10) is an independent factor for predicting adverse outcomes in pediatric patients with hemophagocytic lymphohistiocytosis (HLH). However, little is known about its prognostic value in adult patients. Methods This single center retrospective study was conducted to explore the prognostic value of IL-10 in 101 adults newly diagnosed with HLH. The serum interleukin levels were quantitatively determined by chemiluminescence using cytokine profiling kits. Results Serum IL-10 levels were significantly increased in adult HLH patients. Elevated IL-10 levels was correlated with lower concentrations of hemoglobin (r = − 0.279, P = 0.005). IL-10 levels were significantly lower in patients with macrophage activation syndrome (MAS) than in those with infection-associated HLH (IAHS) and malignancy-associated HLH (MAHS) (P = 0.033, P = 0.012). Patients with MAS had relatively longer survival than those with IAHS and MAHS (P < 0.001). Univariate analysis indicated that hemoglobin < 8.2 g/dL, platelets < 40 × 109/L, lactate dehydrogenase ≥ 700 IU/L, albumin < 28 g/L, post-treatment ferritin > 1050 µg/L and IL-10 ≥ 129 pg/mL were poor prognostic factors for survival. However, multivariate analysis revealed that only high serum IL-10 levels (≥ 129 pg/mL) at diagnosis and high post-treatment ferritin levels (> 1050 µg/L) were independent risk factors for poor overall survival in adult HLH patients (HR: 4.087, 95% CI 2.064–8.090, P < 0.001; HR 3.814, 95% CI 2.042–7.126, P < 0.001, respectively). Conclusions Our results suggest that higher serum IL-10 levels might be a prognostic marker in adult HLH patients.

Elevated Interleukin-10 Levels Are Associated with Low Platelet Count and Poor Prognosis in 90 Adult Patients with Hemophagocytic Lymphohistiocytosis

“…EBV was the main trigger in infectious-related HLH and tended to imply poor survival in our cohort. Nearly all the malignancy-related HLH patients had lymphomas, consistent with other adult HLH studies [3,5,11,14]. It was noteworthy that infections were one of the major complications in patients with malignancies because of immune deficiency.…”

“…Yang et al [13] discovered that IL-6, IL-10, and IFN-γ were moderately or significantly elevated in most adult HLH patients and associated with several clinical features. Furthermore, elevated IL-10 was an independent risk factor for worse outcomes in children and adults with HLH [14,15]. We found that IL-10, IL-6, and IFN-γ were elevated in 93.3%, 91.1%, and 63.3% of patients.…”

“…Relevant research discovered that hypoalbuminemia and increased serum lactic acid were more common in malignancy-related HLH [3,5]. IL-10 was significantly higher in malignancy-related HLH patients compared with MAS [14]. In our cohort, age (p = 0.028), platelet count (p = 0.004), APTT (p = 0.020), and the positive rate of EBV (p = 0.014) were significantly different among the three groups, but the cytokines showed no difference among the three groups.…”

“…Otrock et al [10] found that only malignancy was an independent risk factor for a poor prognosis. Some singlecenter studies from China discovered other parameters that impacted prognosis in adult HLH including IL-10 ≥129 pg/mL, male, IL-6 ≥18.59 pg/mL, APTT >36 s, LDH >1,000 U/L, and CRP >100 mg/L [11,14,23]. A multicenter study suggested that gender, platelet count, albumin, ALT, and treatment regimens were independent prognostic factors for HLH in adults [24].…”

Clinical features and prognostic factors of adult patients with hemophagocytic lymphohistiocytosis: a retrospective study of 130 adult patients

“…The poor prognosis of HLH has been linked to laboratory abnormalities such as low platelet counts, low albumin levels, high bilirubin levels, and high ferritin levels, among others, according to previous research [13,41]. In our cohort, thrombocytopenia was revealed to be an independent predictor for both 30-day mortality and overall mortality.…”