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已发表论文
儿童 ALL 诱导化疗所致中性粒细胞减少期间发生脓毒症的风险因素：一项单中心回顾性研究
Authors Zhao C, Yan M, Yue Y, Zhao L, Liu Y
Received 26 November 2025
Accepted for publication 5 February 2026
Published 7 February 2026 Volume 2026:19 584439
DOI https://doi.org/10.2147/IDR.S584439
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Héctor Mora-Montes
Changda Zhao, Mei Yan, Yingbin Yue, Li Zhao, Yu Liu
Department of Pediatric Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
Correspondence: Yu Liu, Department of Pediatric Center, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan South Road, Xinshi District, Urumqi, Xinjiang, 830054, People’s Republic of China, Tel +86 991-4361253, Email 442620287@qq.com
Objective: To identify clinical factors associated with sepsis during induction chemotherapy–induced neutropenia (CIN) in children with acute lymphoblastic leukemia (ALL).
Methods: This single-center retrospective study included 292 children with ALL who received induction chemotherapy between January 2019 and July 2024. Candidate variables were extracted within 24 hours after the first onset of CIN. Sepsis was defined using the pediatric Sequential Organ Failure Assessment (pSOFA). Univariable Cox regression, collinearity assessment using variance inflation factor (VIF), and multivariable Cox regression analyses were performed to identify risk factors associated with time to sepsis. Kaplan-Meier analyses were used to illustrate sepsis-free survival according to key factors.
Results: Sepsis occurred in 48/292 (16.4%) patients. In multivariable analysis, oral mucosal status (HR=1.336, 95% CI: 1.061– 1.681, P=0.014), C-reactive protein to albumin ratio (CAR) (HR=1.407, 95% CI: 1.088– 1.806, P=0.050), red cell distribution width (RDW) (HR=1.126, 95% CI: 1.028– 1.233, P=0.011), and procalcitonin (PCT) (HR=1.017, 95% CI: 1.002– 1.036, P=0.043) were independently associated with sepsis risk. Kaplan-Meier analyses showed significantly different sepsis-free survival across strata of these factors (all P< 0.05).
Conclusion: Oral mucosal status, CAR, RDW, and PCT were independently associated with sepsis risk during CIN in children with ALL. These findings may inform early risk assessment and warrant confirmation in larger, multicenter cohorts.
Keywords: acute lymphoblastic leukemia, children, sepsis, chemotherapy-induced neutropenia, risk factors, cox regression analysis
Department of Pediatric Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
Correspondence: Yu Liu, Department of Pediatric Center, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan South Road, Xinshi District, Urumqi, Xinjiang, 830054, People’s Republic of China, Tel +86 991-4361253, Email 442620287@qq.com
Objective: To identify clinical factors associated with sepsis during induction chemotherapy–induced neutropenia (CIN) in children with acute lymphoblastic leukemia (ALL).
Methods: This single-center retrospective study included 292 children with ALL who received induction chemotherapy between January 2019 and July 2024. Candidate variables were extracted within 24 hours after the first onset of CIN. Sepsis was defined using the pediatric Sequential Organ Failure Assessment (pSOFA). Univariable Cox regression, collinearity assessment using variance inflation factor (VIF), and multivariable Cox regression analyses were performed to identify risk factors associated with time to sepsis. Kaplan-Meier analyses were used to illustrate sepsis-free survival according to key factors.
Results: Sepsis occurred in 48/292 (16.4%) patients. In multivariable analysis, oral mucosal status (HR=1.336, 95% CI: 1.061– 1.681, P=0.014), C-reactive protein to albumin ratio (CAR) (HR=1.407, 95% CI: 1.088– 1.806, P=0.050), red cell distribution width (RDW) (HR=1.126, 95% CI: 1.028– 1.233, P=0.011), and procalcitonin (PCT) (HR=1.017, 95% CI: 1.002– 1.036, P=0.043) were independently associated with sepsis risk. Kaplan-Meier analyses showed significantly different sepsis-free survival across strata of these factors (all P< 0.05).
Conclusion: Oral mucosal status, CAR, RDW, and PCT were independently associated with sepsis risk during CIN in children with ALL. These findings may inform early risk assessment and warrant confirmation in larger, multicenter cohorts.
Keywords: acute lymphoblastic leukemia, children, sepsis, chemotherapy-induced neutropenia, risk factors, cox regression analysis