To construct a risk assessment model for venous thromboembolism (VTE) in children with acute lymphoblastic leukemia (ALL) after transplantation, and to explore the value of this new model in predicting the risk of post-transplant VTE in children with ALL. A total of 113 children with ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) at Children's Hospital of Soochow University were enrolled. According to the occurrence of VTE within 30 days after transplantation, the children were divided into VTE group and non-VTE group. Differences in the levels of coagulation markers and the distribution of other thromboembolism-related clinical risk factors were compared between the two groups. Logistic regression analysis was used to screen independent risk factors for post-transplant VTE. Based on these factors, a new VTE risk assessment model was established, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the new model for VTE in children with ALL after transplantation, as well as to compare its advantages over traditional methods. In the VTE group, the plasma levels of tissue plasminogen activator-inhibitor complex (t-PAIC), thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer (DD) were significantly higher than those in the non-VTE group, while the fibrinogen (FIB) level was significantly lower (all P < 0.05). In the VTE group, the duration of ALL was generally longer, and the detection rates of granulocytopenia, agranulocytosis, and peripherally inserted central catheter (PICC)-related bloodstream infection (CRBSI) were significantly higher than those in the non-VTE group (all P < 0.05). Multivariate analysis showed that t-PAIC >4.3 ng/ml (OR =30.19, P =0.005) and APTT >31.8 s (OR =12.17, P =0.015) were independent risk factors for post-transplant VTE in children with ALL. A new VTE risk assessment model was established based on these two risk factors. The model showed significantly superior performance in predicting post-transplant VTE in children with ALL compared with individual coagulation and fibrinolysis indicators, as well as the traditional Caprini score and DIC score, with an AUC of 0.90 (P =0.001). The novel thrombotic marker t-PAIC has important clinical value in the early prediction of VTE in children with ALL after HSCT. Compared with the traditional thrombosis risk assessment models, the new model established based on t-PAIC and APTT exhibits superior diagnostic performance and clinical applicability in the pediatric ALL population. 基于出凝血标志物构建急性淋巴细胞白血病患儿移植术后静脉血栓栓塞风险预测模型. 构建一种适用于急性淋巴细胞白血病（ALL）患儿移植后静脉血栓栓塞（VTE）风险的评估模型，探究这种新模型在预测患儿移植后VTE风险中的价值。. 纳入于苏州大学附属儿童医院接受同种异基因造血干细胞移植（HSCT）治疗的ALL患儿113例。根据其在移植后30 d内是否发生VTE，将患儿分为VTE组和非VTE组。比较两组在出凝血相关实验室指标及其他临床危险因素分布方面的差异。采用Logistic回归分析筛选移植后并发VTE的独立危险因素，据此构建新的VTE风险评估模型，并绘制受试者工作特征（ROC）曲线，以评估新模型对ALL患儿移植VTE发生风险的预测效能，并比较其与传统方法间的优势。. VTE组组织型纤溶酶原激活物-抑制剂复合物（t-PAIC）、凝血酶-抗凝血酶复合物（TAT）、纤溶酶-α2纤溶酶抑制剂复合物（PIC）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体（DD）水平均明显高于非VTE组，而FIB水平明显低于非VTE组（均P < 0.05）。VTE组ALL病程普遍较长，且粒细胞减少症、粒细胞缺乏症及PICC相关血流感染的检出率也明显高于非VTE组（均P < 0.05）。多因素分析显示，t-PAIC >4.3 ng/ml（OR =30.19，P =0.005）和APTT >31.8 s（OR =12.17，P =0.015）是ALL患儿移植后发生VTE的独立危险因素。基于上述危险因素构建新的VTE风险评估模型，该模型预测移植后患儿并发VTE的效能明显优于单项出凝血指标和传统Carprini评分、DIC评分，其AUC高达0.90（P =0.001）。. 新型血栓标志物t-PAIC对早期预测ALL患儿移植后VTE具有重要的临床价值。相较于传统血栓风险评估模型，基于t-PAIC和APTT构建的新的VTE风险评估模型在ALL儿童群体中展现出更高的诊断效能与临床适用性。.
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