{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:42:41Z","timestamp":1787794961774,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"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":["Br J Haematol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"Summary<\/jats:title>\n \n To identify early risk factors for disseminated intravascular coagulation (DIC), particularly severe DIC (grade 4\u20135), in paediatric acute promyelocytic leukaemia (APL). One hundred and eighty\u2010six paediatric APL patients enrolled in the Chinese Children Leukemia Group (CCLG)\u2010APL 2016 study across 38 hospitals nationwide were grouped based on the occurrence and severity of DIC during induction therapy. DIC occurred in 52.2% of patients during induction therapy, with 7.5% developing grade 4\u20135 DIC. Significant differences were observed between the DIC and non\u2010DIC groups in the proportion of patients with initial white blood cells (WBC) \u22655\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L, initial platelets (PLT) \u226426\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L and arsenic trioxide (ATO) use (\n p<\/jats:italic>\n \u2009<\u20090.05). Multivariate analysis identified initial PLT \u226426\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L (\n p<\/jats:italic>\n \u2009=\u20090.002, odds ratio [OR]\u2009=\u20092.679, 95% confidence interval [CI]: 1.438\u20134.992) as an independent risk factor, while induction therapy using realgar\u2010indigo naturalis formula (RIF) was a protective factor (\n p<\/jats:italic>\n \u2009=\u20090.030, OR\u2009=\u20090.465, 95% CI: 0.232\u20130.929). Further analysis revealed that Fms\u2010like tyrosine kinase 3 (\n FLT3<\/jats:italic>\n ) mutation (\n p<\/jats:italic>\n \u2009=\u20090.023, OR\u2009=\u200911.742, 95% CI: 1.405\u201398.149), initial PLT \u226426\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L (\n p<\/jats:italic>\n \u2009=\u20090.017, OR\u2009=\u200913.784, 95% CI: 1.598\u2013118.905) and initial bone marrow blasts \u226590% (\n p<\/jats:italic>\n \u2009=\u20090.030, OR\u2009=\u20095.289, 95% CI: 1.178\u201323.744) were significant risk factors for grade 4\u20135 DIC. Initial WBC \u22655\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L and PLT \u226426\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L are associated with an increased risk of DIC, with PLT \u226426\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L as an independent risk factor. Compared with ATO, RIF is a protective factor during induction therapy. Additionally,\n FLT3<\/jats:italic>\n mutation, PLT \u226426\u2009\u00d7\u200910\n 9<\/jats:sup>\n \/L and initial bone marrow blasts \u226590% are independent risk factors for grade 4\u20135 DIC.\n <\/jats:p>","DOI":"10.1111\/bjh.70211","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T11:58:39Z","timestamp":1761220719000},"page":"200-209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors for DIC in paediatric APL: Insights from the CCLG\u2010APL 2016 study"],"prefix":"10.1111","volume":"208","author":[{"given":"Qingyuan","family":"Xu","sequence":"first","affiliation":[{"name":"Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University National Center for Children's Health Beijing Xicheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linya","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University National Center for Children's Health Beijing Xicheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3386-6957","authenticated-orcid":false,"given":"Shaoyan","family":"Hu","sequence":"additional","affiliation":[{"name":"Children's Hospital of Soochow University Suzhou City Gusu District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Liao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Nanning City Qingxiu District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diying","family":"Shen","sequence":"additional","affiliation":[{"name":"The Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Child Health Hangzhou City Gongshu District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Tian","sequence":"additional","affiliation":[{"name":"Kunming Children's Hospital Kunming City Xishan District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoping","family":"Hao","sequence":"additional","affiliation":[{"name":"Children's Hospital of Shanxi Taiyuan City Xinghualing District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runming","family":"Jin","sequence":"additional","affiliation":[{"name":"Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan City Qiaokou District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxin","family":"Li","sequence":"additional","affiliation":[{"name":"Wuhan Children's Hospital Wuhan City Jiang'an District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-6471","authenticated-orcid":false,"given":"Yongjun","family":"Fang","sequence":"additional","affiliation":[{"name":"Children's Hospital of Nanjing Medical University Nanjing City Gulou District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuli","family":"Ju","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University Jinan City Lixia District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Xi'an Children's Hospital Xi'an City Lianhu District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University National Center for Children's Health Beijing Xicheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengli","family":"Huang","sequence":"additional","affiliation":[{"name":"Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University National Center for Children's Health Beijing Xicheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaole","family":"Yu","sequence":"additional","affiliation":[{"name":"Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University National Center for Children's Health Beijing Xicheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University National Center for Children's Health Beijing Xicheng District 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