Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study
Among risk factors for developing thromboembolism (VTE) in children with acute lymphoblastic leukemia were Escherichia coli asparaginase, concomitant steroid use, presence of central venous lines, and thrombophilic abnormalities. Developing a predictive model for determining children at increased ri...
Gespeichert in:
| Veröffentlicht in: | Blood 2010-06, Vol.115 (24), p.4999-5004 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 5004 |
|---|---|
| container_issue | 24 |
| container_start_page | 4999 |
| container_title | Blood |
| container_volume | 115 |
| creator | Mitchell, Lesley Lambers, Moritz Flege, Silke Kenet, Gili Li-Thiao-Te, Valerie Holzhauer, Susanne Bidlingmaier, Christoph Frühwald, Michael C. Heller, Christine Schmidt, Wolfgang Pautard, Brigitte Nowak-Göttl, Ulrike |
| description | Among risk factors for developing thromboembolism (VTE) in children with acute lymphoblastic leukemia were Escherichia coli asparaginase, concomitant steroid use, presence of central venous lines, and thrombophilic abnormalities. Developing a predictive model for determining children at increased risk would be beneficial in targeting interventional studies to high-risk groups (HRGs). Predictive variables were incorporated into a risk assessment model, which was evaluated in 456 children and then validated in 339 patients. VTE risk by score was no greater than 2.5 for low-risk group (LRG) and greater than 2.5 for HRG. VTE rates at 3.5 months (validation cohorts) were 2.5% in LRG and 64.7% in HRG. In multivariate analysis adjusted for age, duration of asparaginase administration, enoxaparin prophylaxis, and T-immunophenotype, the HRG was significantly associated with VTE compared with the LRG (hazard/95% confidence interval [CI], 8.22/1.85-36.53). Model specificity was 96.2% and sensitivity was 63.2%. As secondary objective we investigated the use of enoxaparin for VTE prophylaxis in the HRG. HRG patients without enoxaparin prophylaxis showed a significantly reduced thrombosis-free survival compared with children on low-molecular-weight heparin (LMWH). On the basis of the high specificity, the model may identify children with leukemia at risk of VTE. LMWH may help prevent VTE in the HRG; this warrants assessment in larger cooperative clinical trials. |
| doi_str_mv | 10.1182/blood-2010-01-263012 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2890143</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0006497120348552</els_id><sourcerecordid>754533268</sourcerecordid><originalsourceid>FETCH-LOGICAL-c524t-d034b9bfa9094bcfd7f7025358cbb1fbe38a6fb1afd88354908e8120330e73653</originalsourceid><addsrcrecordid>eNqFks1u1DAUhSMEokPhDRDyBrEK-CfJJCyQqooCUiU2wNbyz3VzqRMPtjNonomXrKcztLCBhWVL_u7x8dGpqueMvmas52-0D8HWnDJaU1bzTlDGH1Qr1vK-ppTTh9WKUtrVzbBmJ9WTlL5TyhrB28fVCadCDLTvVtWvb8qjVRnDTIIjimwiWDQZt0CmYMETFyJBC3NGt8P5iqiZ4GwiqASWREzXt0QeY5h0gLI8pqkgxIzobYSZ_MQ8EmWWDMTvps0YtFcpoyEelmuYUL0lEdLiczpYmMoRTXkRIjFhDDGTlBe7e1o9csoneHbcT6uvF--_nH-sLz9_-HR-dlmblje5tlQ0etBODXRotHF27daUt6LtjdbMaRC96pxmytm-F21TgoCe7SOhsBZdK06rdwfdzaInsHsnUXm5iTipuJNBofz7ZsZRXoWt5P2wj7gIvDoKxPBjgZTlhMmA92qGsCS5bptWCN71_ydFcSUGxgvZHEgTQ0oR3J0fRuW-EPK2EHJfCEmZPBSijL348y93Q78bUICXR0Alo7yLajaY7jk-NLQYvQ8FSvJbhCiTQZhNaUsEk6UN-G8nNyxD2cg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733303912</pqid></control><display><type>article</type><title>Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Mitchell, Lesley ; Lambers, Moritz ; Flege, Silke ; Kenet, Gili ; Li-Thiao-Te, Valerie ; Holzhauer, Susanne ; Bidlingmaier, Christoph ; Frühwald, Michael C. ; Heller, Christine ; Schmidt, Wolfgang ; Pautard, Brigitte ; Nowak-Göttl, Ulrike</creator><creatorcontrib>Mitchell, Lesley ; Lambers, Moritz ; Flege, Silke ; Kenet, Gili ; Li-Thiao-Te, Valerie ; Holzhauer, Susanne ; Bidlingmaier, Christoph ; Frühwald, Michael C. ; Heller, Christine ; Schmidt, Wolfgang ; Pautard, Brigitte ; Nowak-Göttl, Ulrike</creatorcontrib><description>Among risk factors for developing thromboembolism (VTE) in children with acute lymphoblastic leukemia were Escherichia coli asparaginase, concomitant steroid use, presence of central venous lines, and thrombophilic abnormalities. Developing a predictive model for determining children at increased risk would be beneficial in targeting interventional studies to high-risk groups (HRGs). Predictive variables were incorporated into a risk assessment model, which was evaluated in 456 children and then validated in 339 patients. VTE risk by score was no greater than 2.5 for low-risk group (LRG) and greater than 2.5 for HRG. VTE rates at 3.5 months (validation cohorts) were 2.5% in LRG and 64.7% in HRG. In multivariate analysis adjusted for age, duration of asparaginase administration, enoxaparin prophylaxis, and T-immunophenotype, the HRG was significantly associated with VTE compared with the LRG (hazard/95% confidence interval [CI], 8.22/1.85-36.53). Model specificity was 96.2% and sensitivity was 63.2%. As secondary objective we investigated the use of enoxaparin for VTE prophylaxis in the HRG. HRG patients without enoxaparin prophylaxis showed a significantly reduced thrombosis-free survival compared with children on low-molecular-weight heparin (LMWH). On the basis of the high specificity, the model may identify children with leukemia at risk of VTE. LMWH may help prevent VTE in the HRG; this warrants assessment in larger cooperative clinical trials.</description><identifier>ISSN: 0006-4971</identifier><identifier>ISSN: 1528-0020</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2010-01-263012</identifier><identifier>PMID: 20339086</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Adolescent ; Anticoagulants - therapeutic use ; Asparaginase - therapeutic use ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Catheterization, Central Venous - statistics & numerical data ; Child ; Child, Preschool ; Clinical Trials and Observations ; Cohort Studies ; Databases, Factual ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Enoxaparin - therapeutic use ; Escherichia coli ; Hematologic and hematopoietic diseases ; Humans ; Infant ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Medical sciences ; Models, Statistical ; Multivariate Analysis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology ; Predictive Value of Tests ; Reproducibility of Results ; Risk Assessment - methods ; Risk Factors ; Sensitivity and Specificity ; Steroids - therapeutic use ; Thromboembolism - diagnosis ; Thromboembolism - epidemiology ; Thromboembolism - prevention & control</subject><ispartof>Blood, 2010-06, Vol.115 (24), p.4999-5004</ispartof><rights>2010 American Society of Hematology</rights><rights>2015 INIST-CNRS</rights><rights>2010 by The American Society of Hematology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-d034b9bfa9094bcfd7f7025358cbb1fbe38a6fb1afd88354908e8120330e73653</citedby><cites>FETCH-LOGICAL-c524t-d034b9bfa9094bcfd7f7025358cbb1fbe38a6fb1afd88354908e8120330e73653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22940683$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20339086$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mitchell, Lesley</creatorcontrib><creatorcontrib>Lambers, Moritz</creatorcontrib><creatorcontrib>Flege, Silke</creatorcontrib><creatorcontrib>Kenet, Gili</creatorcontrib><creatorcontrib>Li-Thiao-Te, Valerie</creatorcontrib><creatorcontrib>Holzhauer, Susanne</creatorcontrib><creatorcontrib>Bidlingmaier, Christoph</creatorcontrib><creatorcontrib>Frühwald, Michael C.</creatorcontrib><creatorcontrib>Heller, Christine</creatorcontrib><creatorcontrib>Schmidt, Wolfgang</creatorcontrib><creatorcontrib>Pautard, Brigitte</creatorcontrib><creatorcontrib>Nowak-Göttl, Ulrike</creatorcontrib><title>Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study</title><title>Blood</title><addtitle>Blood</addtitle><description>Among risk factors for developing thromboembolism (VTE) in children with acute lymphoblastic leukemia were Escherichia coli asparaginase, concomitant steroid use, presence of central venous lines, and thrombophilic abnormalities. Developing a predictive model for determining children at increased risk would be beneficial in targeting interventional studies to high-risk groups (HRGs). Predictive variables were incorporated into a risk assessment model, which was evaluated in 456 children and then validated in 339 patients. VTE risk by score was no greater than 2.5 for low-risk group (LRG) and greater than 2.5 for HRG. VTE rates at 3.5 months (validation cohorts) were 2.5% in LRG and 64.7% in HRG. In multivariate analysis adjusted for age, duration of asparaginase administration, enoxaparin prophylaxis, and T-immunophenotype, the HRG was significantly associated with VTE compared with the LRG (hazard/95% confidence interval [CI], 8.22/1.85-36.53). Model specificity was 96.2% and sensitivity was 63.2%. As secondary objective we investigated the use of enoxaparin for VTE prophylaxis in the HRG. HRG patients without enoxaparin prophylaxis showed a significantly reduced thrombosis-free survival compared with children on low-molecular-weight heparin (LMWH). On the basis of the high specificity, the model may identify children with leukemia at risk of VTE. LMWH may help prevent VTE in the HRG; this warrants assessment in larger cooperative clinical trials.</description><subject>Adolescent</subject><subject>Anticoagulants - therapeutic use</subject><subject>Asparaginase - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Catheterization, Central Venous - statistics & numerical data</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical Trials and Observations</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Enoxaparin - therapeutic use</subject><subject>Escherichia coli</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Medical sciences</subject><subject>Models, Statistical</subject><subject>Multivariate Analysis</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology</subject><subject>Predictive Value of Tests</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Steroids - therapeutic use</subject><subject>Thromboembolism - diagnosis</subject><subject>Thromboembolism - epidemiology</subject><subject>Thromboembolism - prevention & control</subject><issn>0006-4971</issn><issn>1528-0020</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks1u1DAUhSMEokPhDRDyBrEK-CfJJCyQqooCUiU2wNbyz3VzqRMPtjNonomXrKcztLCBhWVL_u7x8dGpqueMvmas52-0D8HWnDJaU1bzTlDGH1Qr1vK-ppTTh9WKUtrVzbBmJ9WTlL5TyhrB28fVCadCDLTvVtWvb8qjVRnDTIIjimwiWDQZt0CmYMETFyJBC3NGt8P5iqiZ4GwiqASWREzXt0QeY5h0gLI8pqkgxIzobYSZ_MQ8EmWWDMTvps0YtFcpoyEelmuYUL0lEdLiczpYmMoRTXkRIjFhDDGTlBe7e1o9csoneHbcT6uvF--_nH-sLz9_-HR-dlmblje5tlQ0etBODXRotHF27daUt6LtjdbMaRC96pxmytm-F21TgoCe7SOhsBZdK06rdwfdzaInsHsnUXm5iTipuJNBofz7ZsZRXoWt5P2wj7gIvDoKxPBjgZTlhMmA92qGsCS5bptWCN71_ydFcSUGxgvZHEgTQ0oR3J0fRuW-EPK2EHJfCEmZPBSijL348y93Q78bUICXR0Alo7yLajaY7jk-NLQYvQ8FSvJbhCiTQZhNaUsEk6UN-G8nNyxD2cg</recordid><startdate>20100617</startdate><enddate>20100617</enddate><creator>Mitchell, Lesley</creator><creator>Lambers, Moritz</creator><creator>Flege, Silke</creator><creator>Kenet, Gili</creator><creator>Li-Thiao-Te, Valerie</creator><creator>Holzhauer, Susanne</creator><creator>Bidlingmaier, Christoph</creator><creator>Frühwald, Michael C.</creator><creator>Heller, Christine</creator><creator>Schmidt, Wolfgang</creator><creator>Pautard, Brigitte</creator><creator>Nowak-Göttl, Ulrike</creator><general>Elsevier Inc</general><general>Americain Society of Hematology</general><general>American Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QL</scope><scope>7T5</scope><scope>C1K</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20100617</creationdate><title>Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study</title><author>Mitchell, Lesley ; Lambers, Moritz ; Flege, Silke ; Kenet, Gili ; Li-Thiao-Te, Valerie ; Holzhauer, Susanne ; Bidlingmaier, Christoph ; Frühwald, Michael C. ; Heller, Christine ; Schmidt, Wolfgang ; Pautard, Brigitte ; Nowak-Göttl, Ulrike</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c524t-d034b9bfa9094bcfd7f7025358cbb1fbe38a6fb1afd88354908e8120330e73653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Anticoagulants - therapeutic use</topic><topic>Asparaginase - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Catheterization, Central Venous - statistics & numerical data</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical Trials and Observations</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Enoxaparin - therapeutic use</topic><topic>Escherichia coli</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Medical sciences</topic><topic>Models, Statistical</topic><topic>Multivariate Analysis</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology</topic><topic>Predictive Value of Tests</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Steroids - therapeutic use</topic><topic>Thromboembolism - diagnosis</topic><topic>Thromboembolism - epidemiology</topic><topic>Thromboembolism - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mitchell, Lesley</creatorcontrib><creatorcontrib>Lambers, Moritz</creatorcontrib><creatorcontrib>Flege, Silke</creatorcontrib><creatorcontrib>Kenet, Gili</creatorcontrib><creatorcontrib>Li-Thiao-Te, Valerie</creatorcontrib><creatorcontrib>Holzhauer, Susanne</creatorcontrib><creatorcontrib>Bidlingmaier, Christoph</creatorcontrib><creatorcontrib>Frühwald, Michael C.</creatorcontrib><creatorcontrib>Heller, Christine</creatorcontrib><creatorcontrib>Schmidt, Wolfgang</creatorcontrib><creatorcontrib>Pautard, Brigitte</creatorcontrib><creatorcontrib>Nowak-Göttl, Ulrike</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Immunology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mitchell, Lesley</au><au>Lambers, Moritz</au><au>Flege, Silke</au><au>Kenet, Gili</au><au>Li-Thiao-Te, Valerie</au><au>Holzhauer, Susanne</au><au>Bidlingmaier, Christoph</au><au>Frühwald, Michael C.</au><au>Heller, Christine</au><au>Schmidt, Wolfgang</au><au>Pautard, Brigitte</au><au>Nowak-Göttl, Ulrike</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2010-06-17</date><risdate>2010</risdate><volume>115</volume><issue>24</issue><spage>4999</spage><epage>5004</epage><pages>4999-5004</pages><issn>0006-4971</issn><issn>1528-0020</issn><eissn>1528-0020</eissn><abstract>Among risk factors for developing thromboembolism (VTE) in children with acute lymphoblastic leukemia were Escherichia coli asparaginase, concomitant steroid use, presence of central venous lines, and thrombophilic abnormalities. Developing a predictive model for determining children at increased risk would be beneficial in targeting interventional studies to high-risk groups (HRGs). Predictive variables were incorporated into a risk assessment model, which was evaluated in 456 children and then validated in 339 patients. VTE risk by score was no greater than 2.5 for low-risk group (LRG) and greater than 2.5 for HRG. VTE rates at 3.5 months (validation cohorts) were 2.5% in LRG and 64.7% in HRG. In multivariate analysis adjusted for age, duration of asparaginase administration, enoxaparin prophylaxis, and T-immunophenotype, the HRG was significantly associated with VTE compared with the LRG (hazard/95% confidence interval [CI], 8.22/1.85-36.53). Model specificity was 96.2% and sensitivity was 63.2%. As secondary objective we investigated the use of enoxaparin for VTE prophylaxis in the HRG. HRG patients without enoxaparin prophylaxis showed a significantly reduced thrombosis-free survival compared with children on low-molecular-weight heparin (LMWH). On the basis of the high specificity, the model may identify children with leukemia at risk of VTE. LMWH may help prevent VTE in the HRG; this warrants assessment in larger cooperative clinical trials.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>20339086</pmid><doi>10.1182/blood-2010-01-263012</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0006-4971 |
| ispartof | Blood, 2010-06, Vol.115 (24), p.4999-5004 |
| issn | 0006-4971 1528-0020 1528-0020 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2890143 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Anticoagulants - therapeutic use Asparaginase - therapeutic use Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Catheterization, Central Venous - statistics & numerical data Child Child, Preschool Clinical Trials and Observations Cohort Studies Databases, Factual Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Enoxaparin - therapeutic use Escherichia coli Hematologic and hematopoietic diseases Humans Infant Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Medical sciences Models, Statistical Multivariate Analysis Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology Predictive Value of Tests Reproducibility of Results Risk Assessment - methods Risk Factors Sensitivity and Specificity Steroids - therapeutic use Thromboembolism - diagnosis Thromboembolism - epidemiology Thromboembolism - prevention & control |
| title | Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T03%3A01%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Validation%20of%20a%20predictive%20model%20for%20identifying%20an%20increased%20risk%20for%20thromboembolism%20in%20children%20with%20acute%20lymphoblastic%20leukemia:%20results%20of%20a%20multicenter%20cohort%20study&rft.jtitle=Blood&rft.au=Mitchell,%20Lesley&rft.date=2010-06-17&rft.volume=115&rft.issue=24&rft.spage=4999&rft.epage=5004&rft.pages=4999-5004&rft.issn=0006-4971&rft.eissn=1528-0020&rft_id=info:doi/10.1182/blood-2010-01-263012&rft_dat=%3Cproquest_pubme%3E754533268%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=733303912&rft_id=info:pmid/20339086&rft_els_id=S0006497120348552&rfr_iscdi=true |