{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:34:31Z","timestamp":1759937671336},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T00:00:00Z","timestamp":1469664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009096","name":"Taiwan Clinical Oncology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009096","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The diagnosis of hemophagocytic lymphohistiocytosis (HLH) is delayed by most physicians. This study aimed to identify early parameters and suitable scoring systems for the risk of HLH. Clinical and laboratory data collected \u22643\u00a0days after admission were defined as early parameters and used to calculate the number of HLH\u20102004 criteria met and bone marrow (BM) score. Between January 2006 and February 2016, 233 immunocompetent adults with na\u00efve fever of unknown origin who underwent a BM study were enrolled to mimic patients at risk of HLH and randomly assigned into the developmental or validation cohort. Hemophagocytic lymphohistiocytosis was finally diagnosed in 47 patients, with non\u2010Hodgkin lymphoma as the major etiology (51.1%). Upon admission, four\u2010fifths of patients who developed subsequent HLH fulfilled \u22643 of 8 HLH\u20102004 criteria, and 6 early parameters were independent predictors of HLH: anemia (hemoglobin\u00a0&lt;\u00a010\u00a0g\/dL), thrombocytopenia (platelet count\u00a0&lt;\u00a0100\u00a0\u00d7\u00a010<jats:sup>3<\/jats:sup>\/\u03bcL), leukoerythroblastosis, hyperbilirubinemia (total bilirubin\u00a0&gt;\u00a02\u00a0\u00d7\u00a0upper normal limit), hyperferritinemia (ferritin\u00a0&gt;\u00a01000\u00a0ng\/mL), and splenomegaly. Compared with the HLH criteria met upon admission, the BM score was an independent predictor (odds ratio\u00a0=\u00a01.621; 95% confidence interval, 1.355\u20101.940) with excellent discrimination (area under the receiver operating characteristic curve\u00a0=\u00a00.920; 95% confidence interval, 0.883\u20100.958). The sensitivity and specificity for a BM score cutoff of 10 points were 95% and 75%, respectively. When approaching immunocompetent adults with a continuously high fever, the BM score at initial admission assists with early identification of patients at risk of HLH.<\/jats:p>","DOI":"10.1002\/hon.2333","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T09:56:44Z","timestamp":1469699804000},"page":"835-844","source":"Crossref","is-referenced-by-count":7,"title":["Risk of hemophagocytic lymphohistiocytosis in adults with fevers of unknown origin: the clinical utility of a new scoring system on early detection"],"prefix":"10.1002","volume":"35","author":[{"given":"Hao\u2010Yuan","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang\u2010Ming University  Taipei 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Medicine National Yang\u2010Ming University Hospital  Yilan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyh\u2010Pyng","family":"Gau","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan\u2010Bin","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po\u2010Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Chi","family":"Hsu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Division of General Medicine, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Phone","family":"Fung","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Division of Infectious Disease, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiao\u2010Yi","family":"Lin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of 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