Primary Thromboprophylaxis to Prevent Thrombotic Events in Pediatric Oncology Patients with a Malignant Mediastinal Mass.

Abstract

Children with malignant mediastinal masses have increased thrombotic events (TE). We examined primary thromboprophylaxis in reducing TE. Eligible subjects were started on enoxaparin thromboprophylaxis and compared to a cohort without. There were 15 TEs among 76 subjects for an incidence of 19.7%. Mediastinal compression directly led to TE, (M-TE) in 9.2% of subjects requiring 2-fold longer duration of therapeutic anticoagulation. Primary thromboprophylaxis revealed a trend towards reduction in M-TE although not statistically significant. The M-TE subjects had greater superior vena caval compression at diagnosis (p=0.033). We conclude that strategic thromboprophylaxis guided by monitoring dynamic vascular compression can improve TE outcomes.

Venous thromboembolism in pediatric patients with acute lymphoblastic leukemia under chemotherapy treatment. Risk factors and usefulness of thromboprophylaxis. Results of LAL‐SEHOP‐PETHEMA‐2013

“…This study evaluated risk factors related to VTE. Consistent with previous studies, univariant analysis found that patients with a family history of thrombosis, a T‐ALL phenotype, a mediastinal mass at diagnosis, in a high‐risk treatment group or, at least, having an inherited thrombophilia defect, had statistically significant risk factors for VTE 2,3,6,29,30 …”

“…Consistent with previous studies, univariant analysis found that patients with a family history of thrombosis, a T-ALL phenotype, a mediastinal mass at diagnosis, in a high-risk treatment group or, at least, having an inherited thrombophilia defect, had statistically significant risk factors for VTE. 2,3,6,29,30 When each thrombophilia defect was evaluated independently, this association was not found, but when patients with factor II (G20210A) or/and factor V Leiden (G1691A) mutations were evaluated together, a statistically relationship was found.…”