ReviewCureus2026
Prognostic Factors Associated With Mortality in Adult Hemophagocytic Lymphohistiocytosis: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Adult hemophagocytic lymphohistiocytosis (HLH) carries a high case-fatality rate, yet reported prognostic factors are discordant and have never been pooled. The aim of this study was to perform the first systematic review and meta-analysis of prognostic factors for mortality in adult HLH. PubMed/MEDLINE, Embase, Web of Science, and the Cochrane Library were searched (from database inception to February 15, 2026) for observational cohort studies of adults (≥18 years) with HLH diagnosed by the HLH-2004 criteria and/or the HScore, reporting mortality against at least one candidate prognostic factor. Risk of bias was appraised using the Quality In Prognosis Studies (QUIPS) tool, and certainty using GRADE. Random-effects meta-analyses (DerSimonian-Laird with Hartung-Knapp correction) were pre-specified for factors reported in at least three cohorts. Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. A total of 18 cohorts (3,570 adults) were included. Pooled mortality was 49.5% (95% CI: 41.1-57.8), rising from 34.4% (29.0-40.0) within 30 days to 57.3% (47.9-66.4) at longest follow-up (p<0.001). Malignancy-associated HLH carried higher mortality than other triggers (47.1% vs. 32.2%; 12 cohorts, n=2,373; pooled odds ratio 2.53, 95% CI: 1.55-4.12; I²=66.7%). Older age (2.23, 95% CI: 1.57-3.15; I²=0%), hyperferritinemia (3.07, 95% CI: 1.07-8.82), and elevated lactate dehydrogenase (2.02, 95% CI: 1.05-3.88) independently predicted death; thrombocytopenia and prolonged activated partial thromboplastin time were directionally harmful but imprecise. Egger's test indicated small-study effects (p=0.014). Certainty was low to moderate. Approximately half of adults with HLH die following diagnosis, with nearly one-third of deaths occurring within 30 days. A malignant trigger approximately doubles the odds of death; age, ferritin, and lactate dehydrogenase add independent information. Prospective, multinational registry data with pre-specified thresholds are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.