{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:05Z","timestamp":1791352205386,"version":"4.3.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"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. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pegaspargase-induced severe coagulopathy (SC) is a common complication in pediatric acute lymphoblastic leukemia (ALL) treatment, yet reliable predictive tools are limited and its economic burden remains unclear. This study developed and internally validated a clinical prediction nomogram for SC, concurrently created a web-based calculator, and quantified the impact of coagulopathy on the cost of blood products.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using retrospective data from 356 pediatric patients treated according to the Chinese Children\u2019s Leukemia Group Acute Lymphoblastic Leukemia 2018 protocol at Hebei Children\u2019s Hospital between January 2020 and August 2025, SC was defined as grade 4 fibrinogen reduction or grade \u22653 prolongation of the activated partial thromboplastin time. A nomogram was developed via multivariate logistic regression, and cost drivers were analyzed by multiple linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Hypoalbuminemia, elevated bilirubin, and elevated procalcitonin were independent predictors of SC. The nomogram achieved an area under the curve of 0.819 (95% CI: 0.773\u20130.864), and decision curve analysis indicated favorable clinical utility. Blood product cost was primarily driven by patient age, product type, and transfusion frequency (adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.677).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study developed an accurate predictive model for SC and clarified the associated economic burden, providing evidence to support clinical vigilance and inform healthcare resource planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1893967","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:52:54Z","timestamp":1791348774000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk prediction model for pegaspargase-associated severe coagulopathy and blood product costs: a single-center retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiangyu","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Hebei Children\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghao","family":"Xu","sequence":"additional","affiliation":[{"name":"Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]},{"name":"Department of Personnel and Organization, Hebei Children's Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenhong","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Children\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sitong","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deyun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Children\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1053\/j.jvca.2023.10.031","article-title":"Prospective, randomized study of fibrinogen concentrate versus cryoprecipitate for correcting hypofibrinogenemia in cardiac surgery patients","volume":"38","author":"Ayaganov","year":"2024","journal-title":"J. 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