{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:52:31Z","timestamp":1781794351983,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":352,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Information on the etiology and prognosis for leukemoid reaction (LR) in children is still limited and little is known about the factors that distinguish LR from hematological malignancy (HM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single\u2010center, case\u2013control study. Pediatric patients (&lt;18\u2009years) with a white blood cell (WBC) count of 50,000\/\u03bcL or more were included in the study. Clinical information and laboratory test results were extracted from the electronic medical records. Patients were divided into the LR and HM groups. Logistic regression analysis was performed to investigate the factors that discriminated LR from HM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found 214 cases (115 cases in the LR group and 99 cases in the HM group) eligible for analysis. Approximately half of the LR cases were due to infectious diseases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200958, 50%); bacteremia and respiratory infections were the most common infections. Age younger than 2\u2009years (odds ratio [95% confidence interval]) (2.154 [0.690\u20136.727]), presence of known underlying diseases (10.006 [3.119\u201332.102]), WBC count &lt;60,555\/\u03bcL (20.676 [6.357\u201367.251]), platelet count 118,000\/\u03bcL or higher (15.059 [3.876\u201358.504]), lactate dehydrogenase (LDH) below 781\u2009U\/L (4.219 [1.378\u201312.915]), and C\u2010reactive protein (CRP) \u22650.91\u2009mg\/dL (10.568 [2.736\u201340.825]) were identified as the predictive factors for LR by logistic regression analysis. Thirty\u2010day mortality was higher in the LR group than in the HM group but the difference was not statistically significant (13% vs. 6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.087).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately half of the etiology of LR was infectious diseases and prognosis was poorer for LR than for HM. Age, presence of known underlying conditions, and laboratory tests, including WBC count, platelet count, LDH, and CRP, may be useful in distinguishing LR from HM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.15837","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T06:54:33Z","timestamp":1734504873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors distinguishing leukemoid reaction from hematological malignancy in children"],"prefix":"10.1111","volume":"66","author":[{"given":"Heeyung","family":"Kim","sequence":"first","affiliation":[{"name":"Center for Postgraduate Education and Training National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0417-6797","authenticated-orcid":false,"given":"Tatsuki","family":"Ikuse","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medical Subspecialties National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Matsui","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medical Subspecialties National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotoshi","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Children's Cancer Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Ishiguro","sequence":"additional","affiliation":[{"name":"Center for Postgraduate Education and Training National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7164-0262","authenticated-orcid":false,"given":"Kensuke","family":"Shoji","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medical Subspecialties National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit562"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2006.04.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcm006"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24480"},{"issue":"7","key":"e_1_2_8_6_1","first-page":"248","article-title":"Extreme leucocytosis: not always leukaemia","volume":"65","author":"Halkes CJ","year":"2007","journal-title":"Neth J Med"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13127"},{"issue":"3","key":"e_1_2_8_8_1","first-page":"241","article-title":"A prospective study of hospitalized patients with leukemoid reaction; causes, prognosis and value of manual peripheral smear review","volume":"57","author":"Karakonstantis S","year":"2019","journal-title":"Rom J Intern Med"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-018-3155-5"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/340536"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/femspd\/ftw087"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408913"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2021.06.021"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.170969"},{"key":"e_1_2_8_15_1","volume-title":"Principles and practice of pediatric oncology","author":"Allen\u2010Rhoades W","year":"2021"},{"issue":"1","key":"e_1_2_8_16_1","first-page":"55","article-title":"Serum lactate dehydrogenase and its isoenzymes in leukemia patients: possible role in diagnosis and treatment monitoring","volume":"41","author":"Patel PS","year":"1994","journal-title":"Neoplasma"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24420"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.13457"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1400972"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70090-5"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12865"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.15837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T20:25:07Z","timestamp":1764447907000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.15837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/ped.15837"],"URL":"https:\/\/doi.org\/10.1111\/ped.15837","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2024-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15837"}}