Table 3

Overall outcome, course of disease, survival, and sequelae in all patients and in familial patients

All patients, n = 249 (%)Familial patients, n = 60 (%)
Outcome   
    Alive after HSCT 82 (33) 29 (48) 
    Dead after HSCT 42 (17) 15 (25) 
    Alive without HSCT 53 (21) 
    Dead prior to HSCT 72 (29) 16 (27) 
Efficacy of HLH-94 pre-HSCT therapy   
    Admitted to HSCT + alive without HSCT 124 + 53 (71) 44 + 0 (73) 
    Dead during initial or continuation therapy 72 (29) 16 (27) 
Survival   
    5-y cumulative survival, ± 95% CI 54 ± 6 50 ± 13 
    Alive at last follow-up 135 (55) 29 (48) 
Course   
    Alive or HSCT at 2 mo 214 (86) 55 (92) 
    Alive without HSCT at 2 mo 212 (85) 55 (92) 
    NAD* at 2 mo (without HSCT) 122/207 (59) 37/54 (69) 
    Alive or HSCT at 6 mo 196/248 (79) 50 (83) 
    Alive without HSCT at 6 mo 136/188 (72) 30/40 (75) 
HSCT performed 124 (50) 44 (73) 
    Off therapy, no HSCT 49 (20) 
Sequelae in survivors (n = 135) (n = 29) 
    Neurological 25 (19) 9 (31) 
    Non-neurological 21/132 (16) 8/27 (30) 
All patients, n = 249 (%)Familial patients, n = 60 (%)
Outcome   
    Alive after HSCT 82 (33) 29 (48) 
    Dead after HSCT 42 (17) 15 (25) 
    Alive without HSCT 53 (21) 
    Dead prior to HSCT 72 (29) 16 (27) 
Efficacy of HLH-94 pre-HSCT therapy   
    Admitted to HSCT + alive without HSCT 124 + 53 (71) 44 + 0 (73) 
    Dead during initial or continuation therapy 72 (29) 16 (27) 
Survival   
    5-y cumulative survival, ± 95% CI 54 ± 6 50 ± 13 
    Alive at last follow-up 135 (55) 29 (48) 
Course   
    Alive or HSCT at 2 mo 214 (86) 55 (92) 
    Alive without HSCT at 2 mo 212 (85) 55 (92) 
    NAD* at 2 mo (without HSCT) 122/207 (59) 37/54 (69) 
    Alive or HSCT at 6 mo 196/248 (79) 50 (83) 
    Alive without HSCT at 6 mo 136/188 (72) 30/40 (75) 
HSCT performed 124 (50) 44 (73) 
    Off therapy, no HSCT 49 (20) 
Sequelae in survivors (n = 135) (n = 29) 
    Neurological 25 (19) 9 (31) 
    Non-neurological 21/132 (16) 8/27 (30) 

CI indicates confidence interval; NAD, nonactive disease; HLH, hemophagocytic lymphohistiocytosis; and ADHD, attention-deficit/hyperactivity disorder.

*

NAD, as stated by the treating clinician.

Off therapy: Alive without HSCT, no signs of HLH activity, and no HLH therapy for ≥ 1 year.

The most frequently reported neurological sequelae was epilepsy, in 9 patients. Other CNS sequelae ranged from severe mental retardation to speech delay, learning difficulties, motor dysfunctions, cranial nerve paresis and ADHD. Reported non-neurological sequelae included nutritional problems and/or growth retardation, hypertension, impaired renal function, obstructive bronchiolitis, and hearing impairment.

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