Evidence map›Paper›PMID 41398808›Full record

Observational studyMedicine2025

Analysis of risk factors for differentiation syndrome in patients with acute promyelocytic leukemia.

Mingwan Zhang, Huiqing He, Yongbin Ye, Ziwen Guo

Abstract readObservational Study
In one paragraph

Observational study in Medicine, 2025. 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

4 authors.

Mingwan ZhangDepartment of Hematology, Zhongshan City People's Hospital, Zhongshan, Guangdong Province, China.
Huiqing He
Yongbin Ye

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Differentiation syndrome (DS) is a potentially life-threatening complication during induction therapy for acute promyelocytic leukemia (APL). Despite therapeutic advances, early identification of patients at high risk for DS remains clinically critical. This study aimed to investigate clinical, laboratory, and treatment-related risk factors associated with DS in patients with newly diagnosed APL. This retrospective observational study included 316 adult patients diagnosed with APL between January 2014 and December 2024. Diagnosis was confirmed by cytomorphology, immunophenotyping, cytogenetics, and detection of the PML-RARA fusion gene. All patients received induction therapy with all-trans retinoic acid, arsenic trioxide, or both. Clinical and laboratory parameters were compared between DS (n = 96) and non-DS (n = 220) groups. Logistic regression analysis was used to identify independent predictors of DS. The incidence of DS was 30.4%. Compared to the non-DS group, DS patients exhibited significantly higher white blood cell (WBC) counts, neutrophil counts, and percentages of bone marrow and peripheral blood blasts (all P < .001). Coagulation abnormalities (prolonged prothrombin time, reduced fibrinogen) and hypoalbuminemia were more frequent in the DS group. Multivariate analysis identified 3 independent risk factors: absence of prophylactic corticosteroid use (odds ratio [OR] 0.10, 95% confidence interval [CI] 0.03-0.35), elevated peak WBC during induction (OR 1.07, 95% CI 1.03-1.11), and lower baseline serum albumin (OR 0.86, 95% CI 0.79-0.93). Elevated peak WBC, hypoalbuminemia, and lack of prophylactic corticosteroids are independent predictors of DS in APL patients. These findings underscore the importance of early risk stratification and preventive strategies to mitigate DS risk during induction therapy.

Indexed as

Leukemia, Promyelocytic, AcuteAdultAgedAntineoplastic AgentsArsenic TrioxideFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsSyndromeTretinoinYoung AdultAntineoplastic AgentsArsenic TrioxideTretinoinacute promyelocytic leukemiaall-trans retinoic acidarsenic trioxidedifferentiation syndromemultivariate logistic regressionrisk factors

Identifiers

PMID41398808
PMCPMC12708085

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Registered trials

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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.