Venous Thromboembolism in Children with Cancer and Blood Disorders

Abstract

Venous thromboembolism (VTE) in children is multifactorial and most often related to a combination of inherited and acquired thrombophilias. Children with cancer and blood disorders are often at risk for VTE due to disease-related factors such as inflammation and abnormal blood flow and treatment-related factors such as central venous catheters and surgery. We will review risk factors for VTE in children with leukemia, lymphoma, and solid tumors. We will also review risk factors for VTE in children with blood disorders with specific focus on sickle cell anemia and hemophilia. We will present the available evidence and clinical guidelines for prevention and treatment of VTE in these populations.

Need for tissue plasminogen activator for central venous catheter dysfunction is significantly associated with thrombosis in pediatric cancer patients

“…Akin to the reported literature on VTE in patients with sarcoma, it may be that in our study the increased requirement of tPA seen in sarcoma patients is a reflection of the increased incidence of VTE formation …”

How we approach thrombosis risk in children with COVID‐19 infection and MIS‐C

“…Numerous studies have demonstrated an increased rate of VTE in pediatric patients with malignancy. 70,71 Pediatric patients with malignancy can develop severe COVID-19. Current registry data do not show a significantly increased risk for severe infection, and VTE risk is not well studied in this population 72 ; however, a recent study in children shows that malignancy was a risk factor for thrombosis with COVID-19.…”

“…This patient's VTE risks include the diagnosis of active malignancy, central line, and recent asparaginase treatment. Numerous studies have demonstrated an increased rate of VTE in pediatric patients with malignancy 70,71 . Pediatric patients with malignancy can develop severe COVID‐19.…”

Venous Thromboembolism in Children: From Diagnosis to Management

“…Paediatric oncologic patients are at high risk of VTE due to disease and treatment-related factors, e.g., chemotherapy (asparaginase, steroids), CVC use and surgery [ 42 ]. The occurrence of VTE depends on the type of cancer, and acute lymphoblastic leukemia (ALL) is the most common malignancy associated with thrombosis in children (3–14%) [ 43 , 44 , 45 , 46 ].…”