Prognostic Value of D-Dimer/Fibrinogen Ratio at Initial Diagnosis in Children with Acute Lymphoblastic Leukemia
SONG Lili
MA Ping
GUAN Yujie
HUANG Shan
LIU Wei
Abstract：Objective To investigate the prognostic significance of D-dimer/fibrinogen ratio at first visit(DFR)in children with acute lymphoblastic leukemia(ALL).Methods The data of 306 children with ALL who received chemotherapy in Children's Hospital of Zhengzhou University from October 2013 to October 2017 were collected.According to the follow-up results,the children were divided into the good prognosis group and poor prognosis group,and the event-free survival(EFS)was analyzed.The general data,white blood cell count(WBC),platelet count(PLT),lactate dehydrogenase(LDH),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib)and D-dimer(D-D)at first visit were observed and DFR was calculated.The correlation between DFR and other clinical indicators was analyzed,the receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of DFR,and Jorden index was used to determine the best cut-off value.The ALL children were grouped according to the cut-off value of DFR,Kaplan-Meier method was used to analyze its correlation of EFS,and log-rank test was used for comparison between groups.Uunivariate and multivariate Cox regression was used to analyze whether DFR was a prognostic factor for children with ALL.Results DFR was positively correlated with WBC,LDH and TT(P＜0.05).There were significant differences in WBC,Fib,DD and DFR between the good prognosis group and the poor prognosis group(P＜0.05).The results of ROC curve analysis showed that the area under the curve of DFR diagnosis and prognosis was 0.689,the cut-off value was 0.40,the sensitivity was 86.54％,and the specificity was 56.30％.According to the cut-off value,the differenc of EFS in the DFR ≤0.40 group and DFR＞0.40 group was statistically significant(P＜0.001).Multivariate analysis suggested that DFR＞0.40 was an independent risk factor for poor prognosis(P＜0.001).Conclusion DFR at first visit has a certain prognostic significance in children with ALL,and its prognostic value is better than Fib or D-D alone.
Keywords：acute lymphoblastic leukemiachildrenD-dimer/fibrinogen ratiocoagulation indicatorprognosis
Publication Date：2025-02-14
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 411-416 )