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Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.
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Diffuse large B-cell lymphoma (DLBCL) is characterized by heterogeneity with respect to morphology, immune phenotype, molecular pathogenesis, clinical presentation and prognosis. With the development of genome and transcriptome sequencing, DLBCL was classified as four subtypes (EZB, BN2, MCD, and N1) or five subtypes (C1-C5). The new molecular pathological typing has a deeper understanding of DLBCL from the levels of genes and molecules which makes the judgment of prognosis more accurate and specific, and it is conducive to the clinical screening of more accurate targeted therapy.
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Hypoxia inducible factor 1-α(HIF-1α) is a transcription factor induced by hypoxia, and it regulates the transcription of hypoxia-related genes for cells, especially for tumor cells to adapt to the hypoxic environment. HIF-1 α has been widely studied concerning breast cancer, liver cancer and other solid tumors. High expression level of HIF-1 α was related to tumor angiogenesis, metastasis, and chemotherapy-drug resistance. Recent studies showed that HIF-1α was closely related to the pathogenesis and the progress of hematological malignancies such as leukemias, and the expression of HIF-1 α was related to the prognosis of these patients. This paper reviews the research progress of HIF-1α in hematologic malignancies.