{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:45:49Z","timestamp":1792057549839,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intracranial hemorrhage (ICH) is a life\u2010threatening complication of pediatric acute leukemia. However, whether early\u2010onset ICH and late\u2010onset ICH are distinct clinical entities remains unclear. This study investigated the characteristics, neuroimaging findings, and outcomes of ICH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children with newly diagnosed acute leukemia were retrospectively reviewed. Clinical characteristics and OS were compared between patients with and without ICH, while neuroimaging findings and neurological outcomes were evaluated in patients with ICH. Early\u2010onset ICH was defined as hemorrhage within 7\u00a0days after leukemia diagnosis, and late\u2010onset ICH was defined as hemorrhage occurring thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 340 children with acute leukemia, 11 (3.2%) developed ICH. Patients with ICH were significantly younger and more frequently had\n                      <jats:italic>KMT2A<\/jats:italic>\n                      rearrangements, hyperleukocytosis, thrombocytopenia, and coagulation abnormalities than those without ICH. Patients with ICH had a significantly lower 5\u2010year OS rate than those without ICH (55.4% vs. 90.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Early\u2010onset ICH predominantly occurred in patients with acute myeloid leukemia, and it was characterized by multifocal hemorrhages at presentation. Late\u2010onset ICH occurred exclusively in patients with acute lymphoblastic leukemia (ALL). Three infants with\n                      <jats:italic>KMT2A<\/jats:italic>\n                      \u2010rearranged B\u2010cell ALL developed marked cerebral atrophy, followed by subdural hematoma. Five patients required neurosurgical intervention, and all survivors had persistent neurological sequelae.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In pediatric acute leukemia, ICH comprises two clinically distinct patterns. Early\u2010onset ICH is primarily associated with leukemia\u2010related coagulopathy. Late\u2010onset ICH is characterized by cerebral atrophy, followed by subdural hematoma, in infants with\n                      <jats:italic>KMT2A<\/jats:italic>\n                      \u2010rearranged B\u2010cell ALL. Recognizing these distinct patterns may lead to earlier diagnosis, neuroimaging evaluation, and timely neurosurgical intervention.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70767","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:56:32Z","timestamp":1792054592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics of Intracranial Hemorrhage in Pediatric Acute Leukemia"],"prefix":"10.1002","author":[{"given":"Hajime","family":"Kikui","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology Hyogo Prefectural Kobe Children's Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7461-9138","authenticated-orcid":false,"given":"Suguru","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Hematology 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Intensive L\u2010asparaginase, and Protracted Intrathecal Therapy for Newly Diagnosed T\u2010Cell Acute Lymphoblastic Leukaemia in Children and Young Adults (ALL\u2010T11): A Nationwide, Multicenter, Phase 2 Trial Including Randomisation in the Very High\u2010Risk Group","volume":"10","author":"Sato A.","year":"2023","journal-title":"Lancet 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