Impact of baseline clinical and laboratory features on the risk of thrombosis in children with acute lymphoblastic leukemia: A prospective evaluation

Athale, Uma H.; Mizrahi, Terry; Laverdière, Caroline; Nayiager, Trishana; Delva, Yves-Line; Foster, Gary; Thabane, Lehana; David, Michèle; Leclerc, Jean‐Marie; Chan, Anthony

doi:10.1002/pbc.26938

Cited by 19 publications

(30 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study demonstrated that VTE occurred in 7.6% of children during ALL treatment. Multivariable analyses using a case‐control design showed that age ≥7 years was a main risk factor for VTE, thus confirming other studies 24,25 . Accordingly, it is recommended to include age in preventive strategies for VTE during ALL treatment.…”

Section: Discussionmentioning

confidence: 99%

“…showed that age ≥7 years was a main risk factor for VTE, thus confirming other studies. 24,25 Accordingly, it is recommended to include age in preventive strategies for VTE during ALL treatment. An analysis of the developmental hemostatic system showed a relative protective effect against VTE in young infants, compared with adults, with decreased levels of several critical procoagulant factors and increased levels of certain natural anticoagulants.…”

Section: Treatment and Outcome Of Vtementioning

confidence: 99%

See 1 more Smart Citation

Venous thromboembolism in a large cohort of children with acute lymphoblastic leukemia: Risk factors and effect on prognosis

Klaassen

Lauw

Fiocco

et al. 2019

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

Background Venous thromboembolism ( VTE ) is relatively common in children with acute lymphoblastic leukemia ( ALL ). Thrombotic risk factors in ALL are asparaginase and steroids. However, within the ALL populations treated on the same regimen, it is less clear which other risk factors play a role. Furthermore, few data are available on the effect of VTE on ALL outcomes. Methods In 778 children (1‐18 years) with newly diagnosed precursor‐B‐lineage or T‐lineage ALL , treated in the Dutch Childhood Oncology Group ( DCOG ) ALL ‐10 protocol in the Netherlands (October 2004 to April 2013), we conducted a nested case control study with 59 VTE cases and 118 controls to identify risk factors for VTE . Results Fifty‐nine of 778 ALL patients developed VTE (7.6%), with cerebral venous sinus thrombosis ( CVST ) in 26 of 59 patients (44.1%). VTE occurred during induction treatment in 59.3% (n = 35) and in 40.7% (n = 24) during medium risk intensification. Conditional multivariable logistic regression analysis showed that age and ALL subtype were significantly associated with VTE (age ≥7 years: OR 2.72, 95% CI 1.33‐5.57; ALL subtype T‐ ALL : OR 2.95, 95% CI 1.02‐8.57). A multivariable Cox model showed no association between the occurrence of VTE and event free survival. In CVST patients, permanent disability was present in 34.6%. Conclusion Within this large pediatric ALL cohort, we demonstrated a high morbidity in CVST patients. Age ≥7 years at diagnosis and T‐ ALL subtype were the main risk factors for VTE , and should be considered in preventive strategies.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Treatment and Outcome Of Vtementioning

confidence: 99%

Venous thromboembolism in a large cohort of children with acute lymphoblastic leukemia: Risk factors and effect on prognosis

Klaassen

Lauw

Fiocco

et al. 2019

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…8 In children, older age (>7 or 10 years) is one of the main risk factors of symptomatic TE. 1,4,8 Chemotherapeutic agents including Lasparaginase and corticosteroids further enhance the hypercoagulable state. 2,3 In our 9-year-old patient, a huge thrombus was found in the RV, not in common sites of TE such as the upper or lower extremities or central venous sinus.…”

Section: A Huge Right Ventricular Thrombosis and Pulmonary Thromboembmentioning

confidence: 99%

“…One recent study reported that T‐cell subtype of ALL is significantly associated with the development of venous TE 8 . In children, older age (>7 or 10 years) is one of the main risk factors of symptomatic TE 1,4,8 . Chemotherapeutic agents including l ‐asparaginase and corticosteroids further enhance the hypercoagulable state 2,3 …”

Section: Figurementioning

confidence: 99%

“…To the Editor: Thromboembolism (TE) is a significant complication of acute lymphoblastic leukemia (ALL), and it is associated with increased risk of morbidity and mortality. [1][2][3][4] Recent reports showed that chemotherapeutic agents including L-asparaginase and corticosteroids, and patient factors such as age, blood type, and the presence of inherited or acquired thrombophilia may affect the development of TE. 1,2,4 Venous TE usually occurs as deep vein thrombosis in the extremities, pulmonary TE, and cerebral venous sinus TE.…”

Section: A Huge Right Ventricular Thrombosis and Pulmonary Thromboembolism In A Child With Acute Lymphoblastic Leukemiamentioning

confidence: 99%

See 1 more Smart Citation

A huge right ventricular thrombosis and pulmonary thromboembolism in a child with acute lymphoblastic leukemia

Shin

Lee

Kim

et al. 2020

Pediatric Blood & Cancer

View full text Add to dashboard Cite

The incidence and risk factors for venous thromboembolism in adolescent and young adult oncology patients

Hsiao

Krava

Wee

et al. 2021

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background Venous thromboembolism (VTE) is a known complication among pediatric and adult cancer patients. Adolescent and young adult oncology (AYAO) patients have unique biological and physiological characteristics that make them distinct from other populations. Our objective was to study the VTE incidence, risk factors, and outcomes, which have been understudied in this population. Procedure A retrospective case–control study was conducted on AYAO participants with new or relapsed cancer and an imaging confirmed VTE from January 2011 to November 2016 at our institution. Eligible AYAO participants without a history of VTE were designated as controls and were randomly selected from our institution's tumor registry. Demographics, medical history, surgeries, central venous catheter (CVC) data, VTE diagnosis and treatment, relapses, and deaths were abstracted. Results Thirty‐five VTE cases and 70 controls were included in this analysis. Eighty percent of cases had leukemia or lymphoma (vs. a solid tumor) compared to 58% of controls. The majority of VTEs (57%) were CVC associated, and more than 70% of cases had more than one CVC placed during their cancer treatment versus 34% of controls. Infection was associated with increased VTE risk (OR = 6.35, 95% CI = 2.30, 17.55, p < .0001). VTE cases had increased cancer relapse (23% vs. 10%) and mortality rates (29% vs. 16%) than controls. Conclusion AYAO participants with a VTE were more likely to have leukemia or lymphoma, more than one CVC or infection. Further studies are needed to identify patients who would benefit from modifiable prevention measures, such as limiting to one CVC, preventing infections, or considering prophylactic anticoagulation for those with a liquid tumor.

show abstract

Impact of baseline clinical and laboratory features on the risk of thrombosis in children with acute lymphoblastic leukemia: A prospective evaluation

Cited by 19 publications

References 54 publications

Venous thromboembolism in a large cohort of children with acute lymphoblastic leukemia: Risk factors and effect on prognosis

Venous thromboembolism in a large cohort of children with acute lymphoblastic leukemia: Risk factors and effect on prognosis

A huge right ventricular thrombosis and pulmonary thromboembolism in a child with acute lymphoblastic leukemia

The incidence and risk factors for venous thromboembolism in adolescent and young adult oncology patients

Contact Info

Product

Resources

About