Abstract Number: PB0800
Meeting: ISTH 2021 Congress
Background: VTE is a frequent complication of treatment in hospitalized children, but factors, potentially influencing thrombus recanalization rates are still unknown.
Aims: To assess the factors that determine recanalization in children with symptomatic(sVTE) and asymptomatic VTE(aVTE).
Methods: Data of 533 VTE in 1962 hospitalized children aged 0-17 years with ALL, AML, lymphoma, histiocytosis(Hc) and aplastic anemia(AA) was retrospectively analyzed. Information regarding clinical symptoms, thrombus size, type, intensity and time of antithrombotic treatment(ATT) and thrombus recanalization (full/partial) were collected. VTE episodes were divided in sVTE and aVTE. ATT(performed/not performed), therapy quality(correct/incorrect), therapy time(1 month incremental) and diagnosis were referred to ALL cases and added to multivariant logistic regression model(R, the R Project, 4.0.3). ATT was considered as correct in cases when: It was started in 3 days after VTE evaluation; Thrombolytic therapy or surgical thrombectomy performed in cases of life/organ-threating VTE; UFH or LMWH was prescribed in non- life/organ-threating VTE; Close radiographic monitoring with risk reevaluation was performed in cases when there were absolute contraindications for ATT.
Results: In our mixed subset of patients such parameters as therapy, its duration or quality did not show any statistically significant impact on the rate of recanalization in patients with aVTE. In this group, when referred to ALL, OR of recanalization depended only on diagnosis and was highest in patients with lymphoma(7,63; 95%CI 3,09-23,13, Р<0,001), followed by AML(3,15; 95%CI 1,39-7,69, Р=0,008). As for sVTE cases, diagnosis of lymphoma and the fact of correct therapy increased the chance of thrombus recanalization in 4,41(95%CI 1,31-18,62, Р=0,025) and 4,35 times(95%CI 1,44-13,83, Р=0,01), respectively.
Conclusions: Patients with lymphoma have a better prognosis for aVTE and sVTE recanalization, while correct ATT increases the chance of favorable outcome only in the sVTE cases. Summarizing our previously discovered data, it seems that cases of aVTE could potentially have another nature and does not respond to ATT.
To cite this abstract in AMA style:A Zharkov P, A Evstratov D, A Voronin K, V Fedorova D, V Pshonkin A. Factors, Determining Thrombus Recanalization in Children with Different Blood Disorders [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/factors-determining-thrombus-recanalization-in-children-with-different-blood-disorders/. Accessed November 29, 2021.
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