Evidence map›Paper›PMID 41230704›Full record

ArticleHaematologica2026

A scoring system to predict life-threatening thromboischemic events in patients with acute promyelocytic leukemia: the PETHEMA/PALG study.

Rebeca Rodríguez-Veiga, Cristina Gil, Marta Sobas, Laura Torres-Miñana, Carmen Botella, Javier De la Serna, Teresa Bernal, Olga Salamero, Cristina Otero, Irene Navarro-Vicente and 30 more

Abstract read
In one paragraph

Article in Haematologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Rebeca Rodríguez-VeigaHematology Department, Hospital Universitari i Politécnic-IIS La Fe, Valencia.
Cristina GilHematology Department, Hospital General Universitario Dr. Balmis, Alicante.
Marta SobasHematology Department, Wroclaw Medical University.
Laura Torres-MiñanaHematology Department, Hospital Universitari i Politécnic-IIS La Fe, Valencia.
Carmen BotellaHematology Department, Hospital General Universitario Dr. Balmis, Alicante.
Javier De la SernaHematology Department, Hospital Universitario 12 de Octubre, CNIO, Complutense University, Madrid.
Teresa BernalHematology Department, Hospital Universitario Central de Asturias, Instituto Universitario (IUOPA), Instituto de investigación del Principado de Asturias (ISPA), Oviedo.
Olga SalameroUniversity Hospital Vall d'Hebron, and Experimental Hematology, Vall d'Hebron Institute of Oncology, Barcelona.
Cristina OteroHematology Department, Hospital Maciel, Montevideo.
Irene Navarro-VicenteHematology Department, Hospital Universitari i Politécnic-IIS La Fe, Valencia.
Carlos De MiguelHematology Department, Hospital Puerta de Hierro, Madrid.
Ana GarridoHematology Department, Hospital de la Sant Creu i Sant Pau, Barcelona.
Susana VivesHematology Department, ICO-Hospital Universitari Germans Trias i Pujol, Institut de recerca Josep Carreras, Badalona.
Juan BerguaHematology Department, Hospital Universitario San Pedro de Alcántara, Cáceres.
Manuel Pérez-EncinasHematology Department, Hospital Clínico Universitario, Santiago de Compostela.
Lorenzo AlgarraHematology Department, Hospital General Universitario de Albacete, Albacete.
José González-CamposHematology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS / CSIC / CIBERONC), Universidad de Sevilla, Sevilla.
Maria Del Mar Caballero GómezHematology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria.
Maria Virginia PratesHematology Department, Hospital Italiano de La Plata (HILP), La Plata.
Celina BenaventeHematology Department, Hospital Clínico San Carlos, Madrid.
Mar TormoHematology Department, Hospital Clínico Universitario-INCLIVA, Valencia.
Marta CerveraHematology Department, Hospital de Tarragona "Joan XXIII"(ICO-Tarragona), Tarragona.
Patricia FazioHematology Department, Hospital General San Martín, La Plata.
Maria Elena AmutioHematology Department, Hospital Universitario Cruces Barakaldo, Bizkaia.
Raimundo GarcíaHematology Department, Hospital General de Castellón, Castellón.
Helena PomaresHematology Department, Institut Catala d'Oncologia, Hospitalet del Llobregat.
Belén VidrialesHematology Department, Hospital Universitario de Salamanca (HUS/IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca.
Josefina SerranoHematology Department, IMIBIC, Hematology, Hospital Universitario Reina Sofía, UCO, Córdoba.
Mª Luz AmigoHematology Department, Hospital Morales Meseguer, Murcia.
Vicente RubioHematology Department, Hospital General Jerez de la Frontera, Cadiz.
Ágata AlmelaHematology Department, Hospital Universitario de León, León.
Manuel BarriosHematology Department, Hospital Carlos Haya (COMPLEJO HOSPITALARIO REGIONAL DE MÁLAGA), Málaga.
Claudia Lucia Sossa-MeloHematology Department, Fundación Oftalmológica de Santander-FOSCAL Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga-UNAB, Santander, Colombia.
Monika PaluszewskaHematology Department, Medical University of Warsaw, Poland Hematology.
Andrés NovoHematology Department, Hospital Son Espases, Palma de Mallorca.
Tomasz GromekHematology Department, Medical University Lublin (SPSK1), Lublin.
Gabriela Rodríguez-MacíasHematology Department, Hospital General Universitario Gregorio Marañón, Madrid.
Jolanta OleksiukHematology Department, Medical University Bialystok, Białystok.
Pilar Lloret-MadridHematology Department, Hospital Universitari i Politécnic-IIS La Fe, Valencia.
Pau MontesinosHematology Department, Hospital Universitari i Politécnic-IIS La Fe, Valencia. montesinos_pau@gva.es.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute promyelocytic leukemia (APL) is a highly curable leukemia characterized by life-threatening coagulopathy leading to hemorrhagic and thrombo-ischemic events. We analyzed the incidence, outcomes and risk factors of thrombo-ischemic events in a large series of 1,210 patients with newly diagnosed APL reported to the PETHEMA registry. Therapy consisted of ATRA and chemotherapy (AIDA-based). Median age of patients was 46 years (range 2-90 years). Fifty-eight patients (5%) did not start the AIDA regimen either because they were unfit for chemotherapy, or because of early death before initiating ATRA. A total of 195 (16%) patients developed thrombo-ischemic events, the most frequent being superficial-vein and/or central catheter-related (6.9%) followed by central nervous system (2.2%), deep-vein thrombosis (2.1%), pulmonary embolism (2.1%), acute myocardial infarction (1.6%), or other locations (1.2%). Thrombo-ischemic events mostly occurred at diagnosis and during induction (4.0% and 9.3%, respectively). Patients developing life-threatening thrombo-ischemic events (i.e., excluding superficial and/or catheter-related) at diagnosis / induction had a 31% early death rate. Prolonged activated partial thromboplastin time (aPTT), age >40 years, ECOG performance status >1, platelets >25x109/L, and absence of bleeding at presentation were independent risk factors for life-threatening thrombo-ischemic events. Using these variables (1 point each), we developed and validated the Thromb-On risk score, identifying a high-risk group (3-5 points). The Thromb-On risk score was validated in a cohort of 585 patients treated since 2017 with arsenic trioxide plus all-trans retinoic acid (ATRA) (<10x109 leukocytes) or according to the AIDA protocol (≥10x109 leukocytes). This study could help to improve prevention and management of life-threatening thrombo-ischemic events through risk-adapted guidance, potentially leading to a decrease in early mortality in APL.

Indexed as

Leukemia, Promyelocytic, AcuteThrombosisAdolescentAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsChildChild, PreschoolFemaleHumansIncidenceMaleMiddle AgedPrognosisRisk FactorsTretinoin

Identifiers

PMID41230704
PMCPMC13231108

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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.