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Updated: Jun 23, 2026
In vivo Imaging Method to Distinguish Acute and Chronic Inflammation
Published on: August 16, 2013
[Inflammatory indexes during remission induction of pediatric acute leukemia]
Juan Carlos Torres-García1, Carlos Paque-Bautista1, Alma Patricia González1
1Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Gineco Pediatría No. 48, Dirección de Educación e Investigación en Salud. León, Guanajuato, México.
Insights
Inflammatory indexes like the monocyte-lymphocyte ratio (MLR) and neutrophil-lymphocyte ratio (NLR) can predict mortality in pediatric acute myeloid leukemia (AML) patients during remission induction. The systemic immune index (SII) also shows prognostic value for AML mortality.
Area of Science:
- Hematology
- Oncology
- Immunology
Context:
- Acute leukemia (AL) is a severe disease where inflammatory indexes can indicate prognosis.
- Assessing these indexes during remission induction is crucial for pediatric AL patients.
Purpose:
- To determine the prognostic value of inflammatory indexes in predicting mortality during the remission induction phase of pediatric acute leukemia (AL).
Summary:
- This retrolective study analyzed 78 pediatric AL patients. For acute myeloid leukemia (AML), basal monocyte-lymphocyte ratio (MLR) and final neutrophil-lymphocyte ratio (NLR), MLR, and systemic immune index (SII) were significant predictors of mortality.
- While no indexes were significant for acute lymphoblastic leukemia (ALL), for AML, specific cut-off values for MLR, NLR, and SII demonstrated high sensitivity and specificity in predicting death.
Impact:
- Identifies key inflammatory markers (basal MLR, final NLR, MLR, SII) as valuable prognostic tools for mortality risk in pediatric AML patients undergoing remission induction.
- Findings can aid clinicians in risk stratification and personalized treatment strategies for pediatric AML.
Background:
Inflammatory indexes can reflect the severity of serious diseases such as acute leukemia (AL), which is why they can predict mortality.
Objective:
To evaluate the prognostic value of mortality of inflammatory indexes during the remission induction stage in patients with pediatric AL.
Material And Methods:
Observational, longitudinal, analytical and retrolective study. Patients aged 0 to 17 years, with a recent and confirmed diagnosis of AL, who had basal (at diagnosis, before the start of treatment) and final (at the end of remission induction, or, in the cases of death, during the period prior to this outcome) complete blood count were included.
Results:
We included 78 patients, 67 with acute lymphoblastic leukemia (ALL), and 11 with acute myeloblastic leukemia (AML), with 11 and 2 deaths, respectively. Regarding ALL, no index showed significant cut-off points to distinguish deaths. Concerning AML, the indices whose cut-off points distinguished the patients who died in the basal measurement, were the monocyte-lymphocyte ratio (MLR) ≥ 3.11 (sensitivity [Se] 100%, specificity [Sp] 66.67%, AUC 0.8333, p 0.03), and, at the final measurement, the neutrophil-lymphocyte ratio (NLR) ≥ 1.30 and MLR ≥ 0.57 (both with Se 100% and Sp 88.89%, AUC 1.0, p < 0.00001) and systemic immune index (SII) ≥ 246612 (Se 100%, Sp 88.89%, AUC 0.9444, p < 0.0001). With bivariate analysis, only the latter demonstrated an increase in the risk of mortality (p = 0.02).
Conclusions:
The basal MLR and the final NLR, MLR and SII are prognostic inflammatory indices of mortality in patients with AML undergoing remission induction.
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