{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:12:41Z","timestamp":1788415961587,"version":"build-2803163510"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adults with acute leukemia admitted to intensive care have high early mortality. Whether acute lymphoblastic leukemia (ALL) adds prognostic information beyond baseline severity remains clinically important.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective MIMIC-IV cohort study of 486 first ICU stays from 372 adults with acute leukemia. Primary outcomes were hospital and ICU mortality. ALL was compared with a predominantly acute myeloid leukemia comparator using complementary confounder-only and severity-adjusted models and ICD-derived remission stratification, with directional replication in an independent eICU cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ALL admissions were younger and less severely ill at ICU entry. Crude hospital mortality was lower in ALL than in the predominantly AML comparator (23.8% vs. 38.6%; P\u00a0=\u00a00.010). After adjustment for age and comorbidity alone, ALL showed a non-significant reduction in the odds of hospital mortality (adjusted OR, 0.688; 95% CI, 0.385-1.228). Adding first-day Sequential Organ Failure Assessment (SOFA), which partly overlaps with leukemia-related complications, moved this estimate toward the null (adjusted OR, 0.905; 95% CI, 0.485-1.689). ICU-mortality estimates were also non-significant, although the severity-adjusted ICU estimate crossed the null (confounder-only adjusted OR, 0.690; severity-adjusted OR, 1.076). Because first-day SOFA may lie on the subtype-to-outcome pathway, the confounder-only estimate is reported as the total-association estimate (not conditional on the possible mediator), and all confidence intervals remained wide. Model calibration and discrimination were acceptable. In an independent eICU cohort (n=82), the crude and severity-adjusted ALL estimates for hospital mortality (odds ratios 0.667 and 0.445) were likewise non-significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In MIMIC-IV, the crude ALL survival advantage narrowed after adjustment and was not statistically significant. In eICU, crude and severity-adjusted estimates were likewise non-significant but moved further from, rather than toward, the null. Wide confidence intervals in both cohorts, the small ALL sample, overlap between first-day SOFA and leukemia-related complications, and unmeasured leukemia-specific factors leave a modest residual subtype effect possible. These are within-ICU associations affected by selection into intensive care; incomplete post-discharge death ascertainment mainly limits longer-horizon interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1928507","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:15:26Z","timestamp":1788412526000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term mortality after intensive care admission in acute lymphoblastic versus predominantly acute myeloid leukemia: a retrospective cohort study using MIMIC-IV with eICU external replication"],"prefix":"10.3389","volume":"16","author":[{"given":"Zhe","family":"Li","sequence":"first","affiliation":[{"name":"Department of Hematology, Guizhou Provincial People\u2019s Hospital","place":["Guiyang, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianglin","family":"Yu","sequence":"additional","affiliation":[{"name":"The First Clinical College, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-024-01409-9","article-title":"Critically ill adult patients with acute leukemia: a systematic review and meta-analysis","volume":"15","author":"Chean","year":"2025","journal-title":"Ann Intensive Care"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1080\/10428190802353609","article-title":"Outcome and prognostic factors of patients with acute leukemia admitted to the intensive care unit for septic shock","volume":"49","author":"Park","year":"2008","journal-title":"Leuk 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