Red blood cell parameters predict sepsis in children with ALL and chemotherapy-induced neutropenia
This retrospective cohort study examined children with acute lymphoblastic leukemia who received induction remission chemotherapy according to the South China Children's Leukemia Group-ALL-2016 protocol and subsequently developed chemotherapy-induced neutropenia. The initial sample included 264 patients, reduced to 108 after propensity score matching, comprising 75 in the chemotherapy-induced neutropenia (CIN) group and 33 in the sepsis group. Data were collected from the Affiliated Hospital of Guangdong Medical University and Huizhou Central People's Hospital.
The study assessed the predictive efficacy of red blood cell parameters, specifically hemoglobin and red blood cell distribution width (RDW), and their combined model. Comparisons were made between the CIN group and the sepsis group. Analysis revealed that RDW levels and pSOFA scores were significantly higher in the sepsis group compared to the CIN group, with a P value less than 0.05. Conversely, hemoglobin, red blood cell count, and hematocrit levels were significantly lower in the sepsis group.
No safety data, adverse events, or discontinuations were reported in this study. The primary limitation is the retrospective design, although propensity score matching was utilized to address confounding bias. The study did not report funding sources or potential conflicts of interest. While these RBC parameters show statistical associations with sepsis in this specific population, the observational nature of the research precludes establishing causation. Clinicians should interpret these results as indicators of potential risk rather than definitive diagnostic tools.
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