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. 2023 Sep;149(11):8521-8533.
doi: 10.1007/s00432-023-04781-4. Epub 2023 Apr 24.

Serum sCD25/ferritin ratio combined with MCP-1 is a valid predictor for identifying LAHS with HLH as the first manifestation

Heshan Zou  1 , Lingbo He  2 , Zhengjie Hue  1 , Menghan Liu  1 , Shuyan Yao  1 , Yingxin Zhu  1 , Zhao Wang  1 , Yini Wang  3   4
Affiliations

Serum sCD25/ferritin ratio combined with MCP-1 is a valid predictor for identifying LAHS with HLH as the first manifestation

Heshan Zou et al. J Cancer Res Clin Oncol. 2023 Sep.

Abstract

Purpose: Lymphoma-associated haemophagocytic syndrome (LAHS) is a group of malignant diseases with rapid progression and a high mortality rate. Our study aimed to discover the significance of serum sCD25/ferritin ratio as well as cytokines in assisting the diagnosis of LAHS.

Methods: We retrospectively analyzed the clinical data of 82 patients with LAHS with hemophagocytic lymphohistiocytosis (HLH) as the first manifestation and divided them into B-LAHS group and T/NK-LAHS group according to lymphoma pathological diagnosis for comparison. And patients with LAHS were divided into responding group, non-responding group according to the assessment of efficacy after receiving DEP/L-DEP induction therapy for 2 weeks to compare possible valuable indicators.

Results: Serum sCD25/ferritin ratio and MCP-1 levels were significantly different between B-LAHS and T/NK-LAHS groups (P = 0.001, P = 0.022). An sCD25/ferritin ratio > 7.8 tended to suggest a diagnosis of B-LAHS (AUC = 0.71, 95% CI: 0.596-0.823), and the sCD25/ferritin ratio had better predictive value when combined with MCP-1 (AUC = 0.81, 95% CI: 0.699-0.922). The sCD25/ferritin ratio was also significantly different between the two groups responding or not responding to induction therapy (P = 0.002), yielding an optimal cutoff value of 11.48. An sCD25/ferritin ratio > 11.48 tended to suggest that the patient's LAHS was responsive to induction therapy.

Conclusion: Our study reveals that serum sCD25/ferritin ratio combined with MCP-1 is a valid predictor for identifying LAHS with HLH as the first manifestation and may assist in predicting whether the lymphoma is of B-cell or T/NK-cell origin. The sCD25/ferritin ratio can also be used to predict the early response of LAHS after induction therapy.

Keywords: Cytokine; Diagnosis; Ferritin; Hemophagocytic lymphohistiocytosis; Non-Hodgkin lymphoma; sCD25.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Receiver operating curve (ROC) analysis of serum sCD25/ferritin ratio, ferritin, and MCP-1 to predict B-LAHS or T/NK-LAHS are shown, with the endpoint variable of the predictive model was B-LAHS. a The cutoff value of serum sCD25/ferritin ratio corresponding to the maximum of the Youden index was 7.8, with a cutoff value of 2.3 corresponding to higher sensitivity and a cutoff value of 30.1 corresponding to higher specificity. The area under the curve (AUC) is 0.71. b AUC of serum ferritin is presented. c The optimal cutoff value of serum MCP-1 and AUC are presented
Fig. 2
Fig. 2
ROC analysis of serum sCD25/ferritin combined with MCP-1 to predict B-LAHS or T/NK-LAHS are shown. Two separate curves that represent the sCD25/ferritin ratio > 7.8 combined with MCP-1 (the thick solid line) or sCD25/ferritin ratio > 2.3 combined with MCP-1 (the thick dashed line) are presented
Fig. 3
Fig. 3
ROC analysis of serum sCD25/ferritin ratio and ferritin to predict induction therapy response are shown, with the endpoint variable of the predictive model was disease responsive to treatment. a The optimal cutoff value of sCD25/ferritin ratio and AUC are presented. b AUC of serum ferritin is presented
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