{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:38:16Z","timestamp":1792683496738,"version":"4.5.0"},"reference-count":0,"publisher":"The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS","issue":"2","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turkish Journal of Medical Sciences"],"abstract":"<jats:p>Background\/aim: Acute lymphoblastic leukemia (ALL) treatment is frequently complicated by infections, emergency visits, and therapy interruptions, yet early prediction of short-term clinical deterioration remains challenging. Traditional prognostic markers rely on static laboratory values, whereas dynamic hematologic fluctuations may provide earlier warning signals. This study presents and internally validates a clinically applicable prediction model based on dynamic hematologic parameters and clinician-documented symptoms for predicting short-term (7-day) clinical events in children with ALL.\nMaterials and methods:  Included in this retrospective study were 44 pediatric ALL patients treated with Berlin-Frankfurt-M\u00fcnster-based protocols between January 2023 and June 2025. Weekly observation units were created by aggregating complete blood count values and clinician-documented symptoms. Dynamic hematologic indices included mean absolute neutrophil count (ANC), coefficient of variation (ANC-CV), and time in target range (ANC-TTR). The composite outcome was defined as any of the following occurring within 7 days: unplanned emergency visit, \u226548-h chemotherapy interruption, or infection requiring systemic antibiotics. Mixed-effects logistic regression was used to account for within-patient clustering. Model performance was assessed using discrimination, calibration, decision curve analysis, and bootstrap internal validation.\nResults: A total of 1136 weekly observations were analyzed. Composite clinical events occurred in 32.3% of weeks. Event weeks demonstrated lower ANC, higher ANC-CV, reduced ANC-TTR, lower hemoglobin levels, and higher symptom burden (all p &lt;0.01). In the hematology-only model, ANC, ANC-CV, ANC-TTR, hemoglobin levels, and platelet counts were independent predictors (AUROC = 0.77). Adding the symptom score improved discrimination (AUROC = 0.83) and calibration. Decision curve analysis demonstrated greater net clinical benefit for the combined model across threshold probabilities of 10\u201340%.\nConclusion: Dynamic hematologic trajectories and clinician-documented symptoms enable accurate early prediction of short-term clinical events in pediatric ALL. This low-cost, accessible prediction model may support individualized risk stratification and proactive supportive care.<\/jats:p>","DOI":"10.55730\/1300-0144.6183","type":"journal-article","created":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T08:03:26Z","timestamp":1776585806000},"page":"489-496","source":"Crossref","is-referenced-by-count":0,"title":["A model based on dynamic hematologic parameters to predict short term clinical events in pediatric acute lymphoblastic leukemia \u200b"],"prefix":"10.55730","volume":"56","author":[{"given":"NERYAL","family":"TAHTA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SAL\u0130H","family":"G\u00d6ZMEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SULTAN","family":"OKUR ACAR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"34691","published-online":{"date-parts":[[2026,4,14]]},"container-title":["Turkish Journal of Medical Sciences"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:43:22Z","timestamp":1792680202000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.tubitak.gov.tr\/medical\/vol56\/iss2\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,14]]}},"URL":"https:\/\/doi.org\/10.55730\/1300-0144.6183","relation":{},"ISSN":["1300-0144"],"issn-type":[{"value":"1300-0144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]}}}