Clinical and laboratory findings in patients with FHL5
. | Patient A . | Patient B:1 . | Patient B:2 . | Patient C . | Patient D . | Patient E . | Patient F . | Patient G:1 . | Patient G:2 . | Patient H:1 . | Patient H:2 . |
---|---|---|---|---|---|---|---|---|---|---|---|
Ethnic origin | Russia | Pakistan | Pakistan | Pakistan | The Netherlands | The Netherlands | Norway | Denmark | Denmark | Denmark | Denmark |
Familial disease | No | Yes | Yes | No | No | No | Yes | Yes | Yes | Yes | |
Parental consanguinity | No | Yes | Yes | Yes | No | No | No | No | No | No | |
Sex | Female | Female | Male | Female | Female | Male | Female | Female | Male | Male | Female |
Allele 1 | c.1294C>A p.Gln432X | c.1213C>T p.Arg405Trp | c.del769_771 p.Leu257del | c.del224_227ATTT p.Tyr75CysfsX2 | c.116G>C p.Arg39Pro | c.37+5G>A splice error? | c.902+5G>A splice error? | c.902+5G>A splice error? | c.902+5G>A splice error? | ||
Allele 2 | c.1634C>T p.Ser545Leu | c.1247-G>C splice error | c.del769_771 p.Leu257del | c.1247-1G>C splice error | c.1247-G>C splice error | c.1621G>A p.Gly541Ser | c.1247-1G>C splice error | c.1066_1074del; p.His356_Lys358del | c.1066_1074del; p.His356_Lys358del | ||
Age at onset, HLH | 17 y | 4 y | 4 mo | 6 mo | 8.5 mo | 19 mo | 11 mo | 7 y | 12 y | 2 mo | Not applicable |
Age at diagnosis, HLH | 17 y | 9 y | 4 y | 6 mo | 9 mo | 19 mo | 11 mo | 7 y (postmortem) | 12 y | 3.5 mo | 6 mo |
Fever | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
Splenomegaly | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
Hepatomegaly | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes | No | No |
Hemoglobin, g/L | 138 | 72 | 79 | 67 | 108 | 48 | 71 | 80 | 76 | 94 | 114 |
Neutrophils, 109/L | 8.2 | 2.7 | 0.9 | 1.0 | 0.8 | 0 | 0.4 | 0.2 | 0.5 | 1.1 | 1.3 |
Platelets, 109/L | 76 | 15 | 27 | 7 | 91 | 18 | 17 | 40 | 25 | 37 | 280 |
Triglycerides,mM | 2.2 | 3.1 | 4.19 | 5.4 | 4.2 | 6.3 | 4.4 | Elevated | 5.6 | 3.2 | 1.4 |
Fibrinogen, g/L | 1.3 | 0.9 | 1.5 | 1.8 | 1.1 | 1 | 1.6 | Decreased | 5 | < 0.7 | < 0.7 |
Hemophagocytosis | No | No | No | Yes (BM) | Yes (spleen) | Yes (BM) | No | Yes (BM) | Yes (BM) | Yes (ascites and BM) | No |
Ferritin, μg/L | 3101 | 3615 | 256 | 884 | 6100 | 35866 | 848 | 1559 | 2000 | 15 | |
sCD25, U/mL | > 2400 | 3400 | . | ||||||||
Liver transaminases | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Normal | Elevated |
NK-cell activity* | Defective | Defective | ND | Defective | Defective | Defective | Defective | Defective | Defective | Defective | |
NK-cell degranulation | Defective | Defective | ND | Defective | Defective | Defective | Defective | Defective | Defective | ||
Neurologic manifestations† | No | Yes | Yes | No | No | Yes | Yes | Uncertain‡ | Yes | Yes | No |
EBV infection† | Yes | Yes | Yes | No | No | Yes | No | No | No | No | No |
Hypogammaglobulinemia† | Yes | Yes | Yes | No | No | No | No | No | No | No | Yes |
Treatment active disease | HLH-94, rituximab | HLH-2004 | Steroids | HLH-2004 | HLH-2004 | HLH-2004 | HLH-2004 | No | HLH-94 | HLH-2004 | No |
Remission at 2 mo | Yes | Yes | No | Yes | Yes | No | No | Yes | Not applicable | ||
Age at HSCT | Not done | Not done | Not done | Yes | 14 mo | 22/28 mo | 19/24 mo | No | 13 y | 7.5 mo | Donor search started |
Outcome and follow-up | Alive 2 y after onset | Alive 7 y after onset | Dead 4 y after onset | Alive 11 mo after HSCT | Alive 4 y after HSCT | Dead 4 mo after 2nd HSCT | Alive 2 y after 2nd HSCT | Dead 3 mo after onset | Alive 8 y after HSCT | Alive 1 mo after HSCT | Alive |
. | Patient A . | Patient B:1 . | Patient B:2 . | Patient C . | Patient D . | Patient E . | Patient F . | Patient G:1 . | Patient G:2 . | Patient H:1 . | Patient H:2 . |
---|---|---|---|---|---|---|---|---|---|---|---|
Ethnic origin | Russia | Pakistan | Pakistan | Pakistan | The Netherlands | The Netherlands | Norway | Denmark | Denmark | Denmark | Denmark |
Familial disease | No | Yes | Yes | No | No | No | Yes | Yes | Yes | Yes | |
Parental consanguinity | No | Yes | Yes | Yes | No | No | No | No | No | No | |
Sex | Female | Female | Male | Female | Female | Male | Female | Female | Male | Male | Female |
Allele 1 | c.1294C>A p.Gln432X | c.1213C>T p.Arg405Trp | c.del769_771 p.Leu257del | c.del224_227ATTT p.Tyr75CysfsX2 | c.116G>C p.Arg39Pro | c.37+5G>A splice error? | c.902+5G>A splice error? | c.902+5G>A splice error? | c.902+5G>A splice error? | ||
Allele 2 | c.1634C>T p.Ser545Leu | c.1247-G>C splice error | c.del769_771 p.Leu257del | c.1247-1G>C splice error | c.1247-G>C splice error | c.1621G>A p.Gly541Ser | c.1247-1G>C splice error | c.1066_1074del; p.His356_Lys358del | c.1066_1074del; p.His356_Lys358del | ||
Age at onset, HLH | 17 y | 4 y | 4 mo | 6 mo | 8.5 mo | 19 mo | 11 mo | 7 y | 12 y | 2 mo | Not applicable |
Age at diagnosis, HLH | 17 y | 9 y | 4 y | 6 mo | 9 mo | 19 mo | 11 mo | 7 y (postmortem) | 12 y | 3.5 mo | 6 mo |
Fever | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
Splenomegaly | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
Hepatomegaly | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes | No | No |
Hemoglobin, g/L | 138 | 72 | 79 | 67 | 108 | 48 | 71 | 80 | 76 | 94 | 114 |
Neutrophils, 109/L | 8.2 | 2.7 | 0.9 | 1.0 | 0.8 | 0 | 0.4 | 0.2 | 0.5 | 1.1 | 1.3 |
Platelets, 109/L | 76 | 15 | 27 | 7 | 91 | 18 | 17 | 40 | 25 | 37 | 280 |
Triglycerides,mM | 2.2 | 3.1 | 4.19 | 5.4 | 4.2 | 6.3 | 4.4 | Elevated | 5.6 | 3.2 | 1.4 |
Fibrinogen, g/L | 1.3 | 0.9 | 1.5 | 1.8 | 1.1 | 1 | 1.6 | Decreased | 5 | < 0.7 | < 0.7 |
Hemophagocytosis | No | No | No | Yes (BM) | Yes (spleen) | Yes (BM) | No | Yes (BM) | Yes (BM) | Yes (ascites and BM) | No |
Ferritin, μg/L | 3101 | 3615 | 256 | 884 | 6100 | 35866 | 848 | 1559 | 2000 | 15 | |
sCD25, U/mL | > 2400 | 3400 | . | ||||||||
Liver transaminases | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Elevated | Normal | Elevated |
NK-cell activity* | Defective | Defective | ND | Defective | Defective | Defective | Defective | Defective | Defective | Defective | |
NK-cell degranulation | Defective | Defective | ND | Defective | Defective | Defective | Defective | Defective | Defective | ||
Neurologic manifestations† | No | Yes | Yes | No | No | Yes | Yes | Uncertain‡ | Yes | Yes | No |
EBV infection† | Yes | Yes | Yes | No | No | Yes | No | No | No | No | No |
Hypogammaglobulinemia† | Yes | Yes | Yes | No | No | No | No | No | No | No | Yes |
Treatment active disease | HLH-94, rituximab | HLH-2004 | Steroids | HLH-2004 | HLH-2004 | HLH-2004 | HLH-2004 | No | HLH-94 | HLH-2004 | No |
Remission at 2 mo | Yes | Yes | No | Yes | Yes | No | No | Yes | Not applicable | ||
Age at HSCT | Not done | Not done | Not done | Yes | 14 mo | 22/28 mo | 19/24 mo | No | 13 y | 7.5 mo | Donor search started |
Outcome and follow-up | Alive 2 y after onset | Alive 7 y after onset | Dead 4 y after onset | Alive 11 mo after HSCT | Alive 4 y after HSCT | Dead 4 mo after 2nd HSCT | Alive 2 y after 2nd HSCT | Dead 3 mo after onset | Alive 8 y after HSCT | Alive 1 mo after HSCT | Alive |