Lymphocyte subsets in children with hemophagocytic lymphohistiocytosis (HLH) and its clinical significance

Q. An, D.-H. Fang, C.-M. Xuan, S.-M. Xu, M.-W. Jin, Q. Ji

Department of Hematology, Xuzhou Children’s Hospital, Xuzhou, Jiangsu, P.R. China. aiqiangel@yeah.net

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• Hematology

OBJECTIVE: To study the peripheral blood lymphocyte subsets in children with hemophagocytic lymphohistiocytosis (HLH) in acute period as well as remission period, and compare them with healthy children to investigate the significance of lymphocyte subsets in the diagnosis, treatment, and prognosis in children with HLH.

PATIENTS AND METHODS: From January 2009 to March 2014, 30 HLH patients were enrolled in this study. Among them, 20 were placed in the remission group, while 10 cases were placed in the death group. 6 cases died within 8 weeks due to the illness, and 4 cases died within 9 to 34 weeks. 30 children who were confirmed healthy after physical check-ups in the same period were enrolled in the control group. Peripheral blood was collected from both groups and lymphocyte subsets were studied using flow cytometry.

RESULTS: The ratios of CD3+ T and CD8+ T cells increased in the HLH remission group and the death group, while CD4+, CD4+/CD8+ and CD3-CD16+CD56+NK ratios decreased. Difference detected in the proportion of CD19+ B cells was not statistically significant. By comparing lymphocyte subsets in the HLH acute period and the remission period in HLH patients we discovered that the differences in CD3+, CD8+, CD4+ and CD4+/CD8+, CD19+ B cells ratios were not statistically significant (p > 0.05). CD3-CD16+CD56+NK cells ratios in the remission period increased significantly.

CONCLUSIONS: The lymphocyte subsets in children with HLH underwent obvious changes and there was an imbalance in cellular immunity. We believe that dynamic detection of changes may help us to evaluate the prognosis and the effect of the treatment.

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