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Risk factors for early mortality (within 6 weeks of diagnosis) in Chinese children with acute leukemia: a

Li'an Du1,2, Fu Li1,2, Luping Ding1,2

  • 1Department of Hematology and Oncology, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, 250022, China.

Annals of Hematology
|January 26, 2026
PubMed

Insights

Early deaths in childhood acute leukemia (AL) are often caused by intracranial hemorrhage and sepsis. Identifying risk factors like high white blood cell counts and coagulopathy can help guide early interventions for high-risk pediatric patients.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Clinical Research

Background:

  • Acute leukemia (AL) is a significant health concern in children.
  • Early mortality within weeks of diagnosis poses a challenge in pediatric AL management.
  • Identifying risk factors is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To summarize clinical characteristics of pediatric acute leukemia (AL) patients.
  • To analyze risk factors associated with early mortality (within 6 weeks of diagnosis).
  • To identify high-risk patients for targeted early intervention strategies.

Main Methods:

  • Retrospective analysis of data from 242 children diagnosed with primary AL.
  • Evaluation of prognostic value of various indicators for predicting early mortality.
  • Comparison of early mortality rates between acute myeloid leukemia and acute lymphoblastic leukemia.

Main Results:

  • The early mortality rate was 3.72% (9/242), with most deaths occurring within 7 days of treatment initiation.
  • Intracranial hemorrhage (55.56%) and sepsis (33.33%) were the predominant causes of early mortality.
  • Acute myeloid leukemia patients showed significantly higher early mortality and rates of intracranial hemorrhage/cerebral infarction compared to acute lymphoblastic leukemia patients (P<0.01).
  • Risk factors identified include elevated white blood cells (WBC), disturbed serum electrolytes and BUN, and coagulopathy indicators (fibrinogen, INR, PT, aPTT, d-dimer).

Conclusions:

  • Intracranial hemorrhage and sepsis are primary causes of early mortality in pediatric AL.
  • Key risk factors for early death include indicators of tumor burden, internal environment disturbances, and coagulopathy.
  • Early identification of these risk factors can inform clinical strategies to reduce mortality in high-risk pediatric AL patients.

Keywords:
Acute leukemiaEarly mortalityIntracranial hemorrhagePediatricRisk factors

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