ArticleAmerican journal of cancer research2026
Pediatric sequential organ failure assessment score predicts prognosis in children with acute lymphoblastic leukemia and sepsis: association with early multiple organ dysfunction.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo systematically analyze the clinical characteristics and prognostic factors of children with acute lymphoblastic leukemia (ALL) complicated by sepsis, and to compare the predictive efficacy of different scoring systems, with the expectation of providing a basis for early clinical identification of high-risk patients.
methodsA retrospective analysis was conducted on the clinical data of 260 children with ALL who were admitted to the hospital due to sepsis during chemotherapy. Based on their outcomes after admission to the PICU, they were divided into survival (n=184) and death (n=76) groups. General information, disease status at PICU admission, laboratory indicators, and treatment were collected. Univariate logistic regression analysis was used to identify associated factors of mortality, and the predictive efficacy of different scoring systems for prognosis was compared.
resultsBloodstream infection (29.23%), pulmonary infection (27.69%), and multiple site infection (23.46%) were the main infection sites, with bacterial infection being the predominant pathogen (48.85%). Clinical risk classification was predominantly high-risk (45.77%) and intermediate-risk (41.54%), with an overall PICU mortality rate of 29.23%. Univariate logistic regression analysis showed that leukemia remission status (PR/NR), inflammatory markers (CRP, PCT, IL-6), and organ function-related indicators (ALT, AST, TBiL, Scr, BUN, cTnI, CK-MB, BNP) within 48 hours of PICU admission were statistically correlated with mortality (all P<0.05). Furthermore, 24-hour lactate clearance and PaO
conclusionChildren with ALL complicated by sepsis, characterized by bloodstream infection, pulmonary infection, multiple site infection, and intermediate-to-high-risk subtypes, have a higher risk of death upon admission to the PICU. Leukemia remission status, 24-hour lactate clearance, inflammatory response, organ function, and respiratory function indicators within 48 hours of PICU admission are closely related to prognosis. Multidimensional indicators combined with a clinical scoring system can help identify high-risk children early and optimize the timing of PICU intervention, thereby improving prognosis.
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