Main Cause Of Death Research Articles

Outcomes and challenges treating pediatric acute myeloid leukemia: a retrospective analysis of patients treated at the Fundación Valle del Lili between 2011 and 2020

IntroductionAcute myeloid leukemia is a challenging disease, due to a poor prognosis in developing countries. Herein, we aim to describe the clinical characteristics and outcomes after chemotherapy and transplantation. MethodsA retrospective analytic observational study was performed with patients under 18 years of age with newly diagnosed acute myeloid leukemia treated at a referral center in Colombia. Two groups were compared: induction therapy (IT) and induction therapy plus consolidation (IT + C). The survival analysis was performed using the Kaplan–Meier method. ResultsWe analyzed 34 patients diagnosed with acute myeloid leukemia; 20 received hematopoietic stem cell transplantation. Most were French-American-British (FAB) classification types M1, M5 and M0. The transplantation was haploidentical in 65%, conditioning was myeloablative in 67% and graft-versus-host disease prophylaxis was performed with post-transplant cyclophosphamide in 70%. Overall, the 5-year survival was 52% and the overall 5-year survival in the transplanted group was 80%. There were 16 deaths; in the IT group, n = 12, and in the IT + C group, n = 4. In the former, the main cause of death was septic shock and in the latter, it was relapse. ConclusionTransplantation is a safe option. Receiving treatment and supportive measures in hematopoietic stem cell transplantation units is necessary to avoid infections, especially during induction cycles.

Minimally Invasive Microsurgery for Cerebral Contusions

Abstract Introduction Traumatic brain injury (TBI) is among the main causes of death and neurological sequelae worldwide. Injuries are classified as diffuse (diffuse axonal injury and brain swelling) or focal (cerebral contusion [CCo], epidural hematoma, and acute subdural hematoma). Among all TBIs, CCos are the most frequent focal lesion, and treatment modalities are many. Hematoma evacuation using large craniotomies has been well described in the literature. The main goal of the present study is to discuss the advantages of minimally invasive approaches for the treatment of CCos, regarding operative time, blood loss, and postoperative tomographic results. Methods An integrative literature review was conducted on the SciELO, LILACS, and PubMed databases. Seven case reports were included in the present study. Retrospective data collection was performed, analyzing gender, age, Glasgow coma scale score on hospital admission, surgical approach, and postoperative (tomographic) results. Results The minimally invasive keyhole approach was used in seven patients with CCos. The supraorbital approach (n = 5) was performed for frontal lobe contusions, and the minipterional approach (n = 2) was performed for temporal lobe contusions. All cases had adequate hematoma evacuation, confirmed by postoperative computed tomography scans. Conclusion The minimally invasive approaches were effective for hematoma evacuation, with adequate clinical and radiological postoperative results.

Impact of the COVID-19 pandemic on the health of infant children in the Moscow region

The SARS-CoV-2 pandemic has had an impact on the healthcare system and people’s health. The consequences of this influence require study and analysis to further predict population health and healthcare development. Different age groups have significant differences in. features of the disease, epidemiology and consequences. Newborns and infants make up only a small part of the pediatric population affected by COVID-19. Data on the epidemiological and clinical features of COVID-19 in infants are limited. Assessing the impact of the pandemic on this age group through the analysis of morbidity, mortality, hospitalizations, and dispensary observation is of interest to public health. The pandemic has had an impact on public health and public health. The consequences of this influence require comprehensive analysis. The analysis of the main indicators showed that the peak of the pandemic infant children in the Moscow Region occurred in 2021, when the highest incidence and referrals for COVID-19 were registered. The highest level of hospitalization was in 2022. In the period 2020-2021 there was a decrease in morbidity and hospitalizations, which differs from trends in older children and adults. The pandemic had no impact on the coverage of medical examinations of infants, as well as on the mortality rate and the structure of the main causes of death.

Exploring of Breast Cancer Characteristic Features and Their Influences on Survival Rates

Breast cancer stands as the most predominant form of neoplasm and it remains the main cause of cancer-related deaths among females. Over the last four decades; a significant reduction in breast cancer mortality has been achieved due the substantial progress in the management of the disease.This retrospective study aims to evaluate the clinical and pathological features along with breast cancer molecular sub-types in city of Kirkuk-Iraq. In this study data were collected from 280 breast cancer patient who were under the care of Kirkuk oncology center from April 2020 and for nine months, patient's average age was 50.05 years and the most of the patient diagnosed with luminal A breast cancer (57%) of the cases, with the majority (56.9%) falling within the 41 to 50-year-old age range, results shows a significant correlation between menopausal status and the survival rate (p=0.002). A significant correlation (p=0.002) between tumor stage (AIII) and postmenopausal statutes has been noticed. On the same time a higher survival rate (≥5 years) has been recorded among those who diagnosed with tumor stage AIII, whereas in 85% of the cases who diagnosed with tumor stage IV showed survival rate for less than five years. Results from this study highlights the importance of considering the stage and molecular subtypes along with patient's age in the management of the disease and addressing the outcome associated with luminal A (Her2 negative) breast cancer via developing more reliable diagnoses tools and therapeutic targets among different molecular subtypes and finally enhancing women's awareness of the importance of early detection as a principle objective.

Identifying the Risk Factors for Malignant Mammary Tumors in Dogs: A Retrospective Study.

Mammary cancer is one of the main causes of death in female dogs worldwide, considering that many risk factors are involved in its development. This study aimed to elucidate the relationship between epidemiological and clinical risk factors with the histopathological diagnosis of malignant mammary tumors in dogs treated at the Veterinary Hospital of the Federal University of Uberlândia, which has one of the first veterinary oncology services in Brazil. A retrospective matched case-control study was conducted to identify risk factors for the development of malignant mammary tumors in dogs. The variables analyzed were size dog, breed, housing, type of diet, and body score. Potential risk factors were selected by univariate analysis (p < 0.25) before multivariate forward binary logistic regression. The most frequent benign tumor was the benign mixed tumor (35.2%), and the most frequent malignant tumor was the mixed carcinoma (27.4%). Size dog, breed, housing, and overweight are predictors of malignant mammary tumors in dogs. The highest risk of developing malignant mammary tumors is associated with large female dogs, Yorkshire or Poodle breeds, living outside the home, or being overweight.

Restrictive versus high-dose oxygenation strategy in post-arrest management following adult non-traumatic cardiac arrest: a meta-analysis

PurposeNeurological damage is the main cause of death or withdrawal of care in comatose survivors of cardiac arrest (CA). Hypoxemia and hyperoxemia following CA were described as potentially harmful, but reports were inconsistent. Current guidelines lack specific oxygen targets after return of spontaneous circulation (ROSC).ObjectivesThe current meta-analysis assessed the effects of restrictive compared to high-dose oxygenation strategy in survivors of CA.MethodsA structured literature search was performed. Randomized controlled trials (RCTs) comparing two competing oxygenation strategies in post-ROSC management after CA were eligible. The primary end point was short-term survival (≤ 90 days). The meta-analysis was prospectively registered in PROSPERO database (CRD42023444513).ResultsEight RCTs enrolling 1941 patients were eligible. Restrictive oxygenation was applied to 964 patients, high-dose regimens were used in 977 participants. Short-term survival rate was 55.7% in restrictive and 56% in high-dose oxygenation group (8 trials, RR 0.99, 95% CI 0.90 to 1.10, P = 0.90, I2 = 18%, no difference). No evidence for a difference was detected in survival to hospital discharge (5 trials, RR 0.98, 95% CI 0.79 to 1.21, P = 0.84, I2 = 32%). Episodes of hypoxemia more frequently occurred in restrictive oxygenation group (4 trials, RR 2.06, 95% CI 1.47 to 2.89, P = 0.004, I2 = 13%).ConclusionRestrictive and high-dose oxygenation strategy following CA did not result in differences in short-term or in-hospital survival. Restrictive oxygenation strategy may increase episodes of hypoxemia, even with restrictive oxygenation targets exceeding intended saturation levels, but the clinical relevance is unknown. There is still a wide gap in the evidence of optimized oxygenation in post-ROSC management and specific targets cannot be concluded from the current evidence.

Arrhythmias in children and adolescents as a cause of chest pain

Arrhythmias are a relatively common cause of chest pain in children and adolescents, which should be considered in the differential diagnosis of pain. The article points to modern ideas about the different etiology of arrhythmias in children and adolescents. It also presents a working classification of arrhythmias based on their pathophysiological mechanisms, a brief diagnosis of arrhythmias including clinical criteria, various instrumental and ultrasound examination methods; described group of life-threatening arrhythmias, which are considered one of the main causes of sudden cardiac death. The characteristics of each type of life-threatening arrhythmia are listed at the end of the article. Treatment includes medical and surgical methods.

Intrauterine death in vasa previa without hemorrhage: case reports

Antepartum and intrapartum hemorrhage from vasa previa (VP) is one of the main causes of intrauterine fetal death (IUFD). Here, we present two cases with type I VP in which velamentous cord insertion below the fetal head and overlying the cervix were reported by prenatal ultrasound scanning, and IUFD occoured after 35 weeks with no signs of prenatal bleeding but with engaged fetal head at presentation. We hypothesized that the IUFD may attributed to the compression of the unprotected umbilical vessels by the engaged fetal head. Thus we suggest that VP with a velamentous cord insertion should be considered for earlier termination of the pregnancy to avoid the risk of non-hemorrhagic adverse fetal outcomes.

Death rate and causes of death in the neonatal intensive care unit in the Children Welfare Teaching Hospital (2018-2021)

Background: The first month of life is the most vulnerable period and mortality during this period is an important component of under-5 mortalities. Causes of death in this period are preventable like sepsis, RDS, and asphyxia, while others are not like multiple congenital abnormalities. Objectives: To study the death rate and main causes of death in the neonatal intensive care unit (NICU) of the Children Welfare Teaching Hospital (CWTH) through the period (2018-2021). Patients and methods: The death per year for the four years of the study and causes of death were collected retrospectively and analyzed for total death rate and rate for each year, sex distribution, male-to-female ratio, early and late death rate, and main causes of death. Results: it was found that the total death rate is 17.3%, male: female ratio 1.6: 1. The early neonatal death was 54.3% and the late neonatal death was 45.6%. The main causes are congenital anomalies (39%), sepsis (17.4%), prematurity (16.9%), RDS (10.8%), postoperative complications (7.5%), and birth asphyxia (1.9%). Conclusions: The death rate in the NICU / CWTH is still high despite improvement in respiratory care and the use of invasive and noninvasive respiratory support. The death rate because of congenital abnormalities was the main cause of death. Received: Dec,, 2022 Accepted: July, 2023 Published: Oct.2023

Prehospital blood transfusion in Brazil: results of the first year of implementation in an emergency medical service

IntroductionHemorrhagic shock is the main cause of death in the prehospital environment, which highlights the need to standardize measures aiming at bleeding control and volume replacement in this environment. In Brazil, the first prehospital packed red blood cell transfusion service started in September 2020, in Bragança Paulista, state of São Paulo. ObjectivesDescribe the trends and characteristics of patients who received prehospital transfusions prior to hospital treatment during the first year of operation. MethodsA retrospective data review was made of all patients who received transfusions from the mobile intensive care unit in Bragança Paulista over one year. ResultsIn this period, 19 patients were transfused. Since activation, the average response time was 20 min. The mean shock indexes before and after blood transfusion were 2.16 and 1.1, respectively. During the course of the 1st year of prehospital transfusions, no blood was wasted and there were no adverse effects. ConclusionIntroduction of the prehospital packed red blood cell transfusion service was successful, with significant improvement in hemodynamic parameters.

Lynch Syndrome: Approach from the Gastroenterologist’s Point of View

"Colorectal cancer is one of the main causes of death by cancer in the European Union and in Romania. Lynch Syndrome is an autosomal dominant inherited disease that affects around 3% of all colorectal cancer patients, defined by mutations in the mismatch repair genes (MLH1, MSH2, MSH6, PMS2). Aside from the high risk for colorectal cancer (CRC), they exhibit a high risk for endometrial cancer, ovarian cancer, gastric cancer, pancreatic cancer, brain cancer, small bowel cancer, and sebaceous gland cancer. Diagnosis is often made by the gastroenterologist, usually when he meets a young patient with symptoms suggesting the presence of a colonic tumor and a family history of CRC. The role of the gastroenterologist is to investigate the best practices in order to have an early diagnosis and to prevent interval cancers according to the newest guidelines or other gastrointestinal tract tumors associated with Lynch Syndrome. Registries play an important role in the optimal surveillance of these particular categories of patients and should be put into place in every country. They will allow clinicians to have a better understanding of the disease and a more standardized quality of care for them."

Unintentional injuries in children in the south of Iran, 2004–2019: a trend analysis of mortality rates

IntroductionInjury is one of the main causes of death and disability in the world. This study was designed to determine the trend of mortality rate and years of life lost...

Causes of mortality among adults with Down syndrome before and after the COVID-19 pandemic in Spain.

The life expectancy of people with Down syndrome (DS) is limited by Alzheimer's disease (AD)-related deaths, mainly due to respiratory infections. The emergence of the COVID-19 pandemic could have changed known, past trends in mortality in this population. We analysed the differences in causes of mortality between individuals with DS deceased before and after the onset of the pandemic. This is a cross-sectional study of adults with DS recruited at a tertiary, university outpatient clinic in Madrid, Spain. Demographic and clinical data were retrospectively collected from their medical records, including information on their deaths, if any. Five hundred seventy-two adults were included in the study, and 67 (11.7%) died. The main cause of death was respiratory infections, which occurred in 36 participants [9 (45.0%) before, and 27 (58.7%) after the appearance of COVID-19]. No significant differences were found in the determinants of pre-pandemic and post-pandemic death after adjusting for age and AD, except for an association between the use of psychotropic medication and death in the post-pandemic period (odds ratio: 2.24; 95% confidence interval: 1.04-4.82). Vaccination against COVID-19 showed a marked protective effect against mortality (odds ratio: 0.0002; 95% confidence interval: 6.7e10-6 to 0.004). The appearance of COVID-19 has not impacted the overall trend of increase in mean age of death of adults with DS in our milieu, probably thanks to the very important protective effect of vaccination, which supports prioritising people with DS in future immunisation campaigns. The association between psychotropic medication use and mortality requires further exploration.

Automatic Evaluating of Multi-Phase Cranial CTA Collateral Circulation Based on Feature Fusion Attention Network Model.

Stroke is one of the main causes of disability and death, and it can be divided into hemorrhagic stroke and ischemic stroke. Ischemic stroke is more common, and about 8 out of 10 stroke patients suffer from ischemic stroke. In clinical practice, doctors diagnose stroke by using computed tomography angiography (CTA) image to accurately evaluate the collateral circulation in stroke patients. This imaging information is of great significance in assisting doctors to determine the patient's treatment plan and prognosis. Currently, great progress has been made in the field of computer-aided diagnosis technology in medicine by using artificial intelligence. However, in related research based on deep learning algorithms, researchers usually only use single-phase data for training, lacking the temporal dimension information of multi-phase image data. This makes it difficult for the model to learn more comprehensive and effective collateral circulation feature representation, thereby limiting its performance. Therefore, combining data for training is expected to improve the accuracy and reliability of collateral circulation evaluation. In this study, we propose an effective hybrid mechanism to assist the feature encoding network in evaluating the degree of collateral circulation in the brain. By using a hybrid attention mechanism, additional guidance and regularization are provided to enhance the collateral circulation feature representation across multiple stages. Time dimension information is added to the input, and multiple feature-level fusion modules are designed in the multi-branch network. The first fusion module in the single-stage feature extraction network completes the fusion of deep and shallow vessel features in the single-branch network, followed by the multi-stage network feature fusion module, which achieves feature fusion for four stages. Tested on a dataset of multi-phase cranial CTA images, the accuracy rate exceeding 90.43%. The experimental results demonstrate that the addition of these modules can fully explore collateral vessel features, improve feature expression capabilities, and optimize the performance of deep learning network model.

Genetic Polymorphism in FSCN1 rs3801004 C/G and CD44 rs353639 A/C, as Prognostic Factor in Egyptian Breast Cancer Patients.

One of the main causes of cancer-related deaths is breast cancer. Fascin-1(FSCN1) is an actin-binding protein that is present in the mesenchymal, neuronal, and endothelial cells of mammals. Patients with breast cancer have been found to have FSCN1 overexpression. CD44 is crucial for the development, invasion, and tumour spread. Therefore, we aimed to investigate the role of FSCN1&CD44 gene polymorphisms in breast cancer (BC) risk and prognosis. A total of 96 BC patients and 50 controls were included in the case-control study for risk prediction. We examined the association between The SNPs on FSCN1(rs3801004) and CD44(rs353639) and BC susceptibility and clinicopathological features using a real-time PCR in a cohort of the Egyptian population. Results: A significant association of both SNPs on FSCN1(rs3801004)C allele and CD44(rs353639)A allele and BC susceptibility(adjusted OR=4.38,95%CI:2.6-7.4,p<0.001, and adjusted OR=4.44,95%CI:2.65-7.44,p <0.001,respectively). Moreover, CC genotype in FSCN1(rs3801004) were likely to progress to developing G2&G3 and N2&N3 and stage II & stage IV, according to the TNM staging and GG+GC genotypes increased within individuals who had a positive family history of BC. Individuals who carry at least one A allele for CD44rs353639 were likely to progress developing N2 according to the TNM in BC patients. These findings suggest that both SNPs on FSCN1 (rs3801004) and CD44 (rs353639) affected BC susceptibility. FSCN1 (rs3801004) genetic variants may have a significant effect on BC prognosis. However, CD44 (rs353639) affected lymph node invasions in BC patients.

Dataset and Feature Analysis for Diabetes Mellitus Classification using Random Forest

Diabetes Mellitus is a hazardous disease, and according to the World Health Organization (WHO), diabetes will be one of the main causes of death by 2030. One of the most popular diabetes datasets is PIMA Indians, and this dataset has been widely tested on various machine learning (ML) methods, even deep learning (DL). But on average, ML methods are not able to produce good accuracy. The quality of the dataset and features is the most influential thing in this case, so deeper investment is needed to examine this dataset. This research will analyze and compare the PIMA Indians and Abelvikas datasets using the Random Forest (RF) method. The two datasets are imbalanced, in fact, the Abelvikas dataset is more imbalanced and has a larger number of classes so it is be more complex. The RF was chosen because it is one of the ML methods that has the best results on various diabetes datasets. Based on the test results, very contrasting results were obtained on the two datasets. Abelvikas had accuracy, precision, and recall, reaching 100%, and PIMA Indians only achieved 75% for accuracy, 87% for precision, and 80% for the best recall. Testing was done with 3, 5, 7, 10, and 15 tree number parameters. Apart from that, it was also tested with k-fold validation to get valid results. This determines that the features in the Abelvikas dataset are much better because more complete glucose features support them.

Prevalence and Associated Factors of Neonatal Sepsis among Neonates Admitted at Neonatal Intensive Care Units of Hargeisa Hospitals, Somaliland, 2023

Background: Neonatal sepsis is the main cause of neonatal death and morbidity worldwide. It is characterized by a systemic inflammatory response during the clinical course of infection which manifests within the first month of life of a newborn. Neonatal sepsis accounts for 7% of all neonatal deaths in Somalia. However, we know little about the prevalence and factors associates with neonatal sepsis in Somaliland. As a result, this study is aimed to assess the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at Hargeisa Hospitals in Somaliland. Methods: Institutional-based cross-sectional study was conducted among 244 medical records of neonates admitted in neonatal intensive care units of Hargeisa Hospitals from May, 2023 to June, 2023. The medical records selected at random using lottery method. Neonatal record review used to collect data using structured pretested checklist. Data entered into Epidata version 3.1 and analyzed with SPSS version 22. Bivariable and multivariable binary logistic regression used to identify associated factors at a 95% confidence interval. Significance is considered at p-value &lt; 0.05, Multi-collinearity is examined (VIF &lt;10) and Model fitness is evaluated using Hosmer-Lemeshow statistic test (P&lt; 0.05). Result: The overall prevalence of neonatal sepsis in this study was 28.69% (95% CI, 22.97-34.40). Neonates whose mothers’ membranes had ruptured before giving birth (AOR=1.9; 95% CI: 1.01-3.61) and neonates delivered through assisted vaginal delivery (AOR=3.9; 95% CI: 1.19-12.64) had a positive association with neonatal sepsis than their counterparts. Recommendations: Hospitals and health professionals should enhance early detection and management of mother with PROM. Health professionals should give particular consideration to the neonate through vaginal delivery.

MEMAHAMI PERILAKU KETIDAKPATUHAN PENGGUNAAN OBAT DI KALANGAN PENDERITA PENYAKIT HIPERTENSI: APLIKASI TEORI HEALTH BELIEF MODEL

Hypertension disease is one of the risk factors for cardiovascular and blood vessel disease which is increasing constantly through the world and it is the main cause of premature death. Currently, the therapy that used for hypertension is antihypertensive treatment and applying the healthy lifestyle. Adherence in using antihypertensive medications is very important to achieve controlled hypertension. However, there are many nonadherence behaviors in the use of drugs that can cause a decrease in the patient’s quality of life. This study aimed to explore factors related to patient’s adherence in antihypertensive medications using Health Belief Model theory. This research is a qualitative study through deep interviews with open-ended questions. Respondents were all hypertension patients with minimum 3 months treatment of antihypertensive medications. Interviews were conducted using an interview guide compiled based on HBM constructs. Data were analyzed with content analysis. Result: 34 respondents were interviewed. Most respondents have high adherence in antihypertensive treatment 62% and 38% respondents have low adherence. This behavior is influenced by the low perception of susceptibility and severity to hypertension, which is caused by a lack patient knowledge. In addition, the high perception of barrier and the lack of perceived benefits when taking medication regularly also affects the level of patient nonadherence. Conclusion: Nonadherence behavior to antihypertensive medications was noticed in 38% of the respondents studied. Interventions strategies aiming to improve adherence can be done through patient education and using the electronic reminders.

The Causes of Death and Conditional Survival for Long-Term Survivors of Thymoma

Data on the morality cause for long-time survival of thymoma is limited. The previous study hinted that thymoma may be a chronic disease rather than a curable cancer. we performed a large-scale retrospective analysis to assess long-term cause of death in patients with thymoma. This study reviewed thymoma patients from the Surveillance, Epidemiology, and End Results (SEER) database between January1975 and December 2016.Conditional survival and annual hazard rates was calculated with Kaplan-Meier, and cause-specific mortality was performed using Fine-Gray competing risks analysis. Of 3105 patients were identified (median [range] age,58 (18-93), years), 1615 (52.0%) were male,1028(33.1%) were 65 years or older and 1360(43.8%)patients was at locally advanced (IIB-III) disease. The 10-year overall survival (OS) and cancer-specific survival (CSS) rates were 55.5% (95% CI, 53.4-57.6%) and 74.4% (95% CI, 72.4-76.3%) respectively. Smoothed hazard showed that the annual overall death hazard of death increased steadily, but the hazard of thymoma-related death began to decline at about 4 years and is exceeded by other causes at death. However, the annual risk of death by thymoma remain about 1-2% at 5-25 years. Similarly, the conditional OS increased slowly with increased survival time however the cancer-specific survival based decreased slowly. The cumulative incidence of the most common causes of death was 23.1% for thymoma, 5.4% for heart of disease, and 3.9% for the second cancer in 10 years, 28.5%,8.3 and 7.0% in 15 years, and 31.8%,11.8% and 10.8% in 25 years. After 5 years of survival, the death of heart was the main cause of non-thymoma death. The 10-years survivors' older patients (≥65 years) or with radiotherapy suffered more heart specific death (adjust P< 0.001, P = 0.015, respectively). The risk of cancer-specific death and other causes of death shift over time for patients with thymoma. The non-cancer cause, especially heart diseases which may be the vital competing cause of death, increased with prolongation of survival time.

Clinical characteristics and risk factors of acute lymphoblastic leukemia in children with severe infection during maintenance treatment.

Infection is the most common adverse event of acute lymphoblastic leukemia (ALL) treatment and is also one of the main causes of death. To investigate the clinical characteristics and risk factors of severe infections during the maintenance phase of ALL treatment, we conducted a retrospective study. A total of 181 children were eligible and 46 patients (25.4%) suffered from 51 events of severe infection, most of which occurred in the first half year of the maintenance phase (52.9%). The most common infection was pulmonary infection (86.3%) followed by bloodstream infection (19.6%). The main symptoms of ALL patients with pulmonary infection were fever, cough, and shortness of breath. The main manifestations of computer tomography (CT) were ground glass shadow (56.8%), consolidation shadow (27.3%), and streak shadow (25%). Multivariate binary logistic regression analysis showed that agranulocytosis, agranulocytosis ≥7 days, anemia, and low globulin level were independent risk factors for severe infection during the maintenance phase (all p < 0.05). Taken together, blood routine examinations and protein levels should be monitored regularly for ALL patients in the maintenance phase, especially in the first 6 months. For ALL patients with risk factors, preventive anti-infective or supportive therapies can be given as appropriate to reduce the occurrence of severe infections.