Abstract Number: PB1102
Meeting: ISTH 2021 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Lymphoma is the third most common cancer in children and adolescents. Venous thromboembolism (VTE) is a frequent complication in pediatric patients with lymphomas, but there is lack of data about risk factors for symptomatic VTE (sVTE) in this cohort of patients.
Aims: To evaluate risk factors for VTE in children and adolescents with lymphomas.
Methods: Our study is a monocentric retrospective analysis of 262 patients aged <18 years with lymphoma that were treated in our Center since 2013 to 2019 year. The epidemiological characteristics of patients are presented in table 1.
| Characteristic | Patients without sVTE (%) | Patients with sVTE (%) | P, Chi-square |
| ABO – Group O | 84 (34.9%) | 3 (14.3%) | P=0.057 |
| ABO – Group “Non-O” | 157 (65.1%) | 18 (85.7%) | |
| Hodgkin lymphoma | 75 (31.1%) | 9 (42.9%) | P=0.27 |
| Non-Hodgkin lymphoma | 166 (68.9%) | 12 (57.1%) | |
| Mediastinal involvement – | 159 (66%) | 6 (28.6%) | P=0.001 |
| Mediastinal involvement + | 82 (34%) | 15 (71.4%) | |
| Intensive care unit treatment during the first 30 days of hospitalization – | 200 (83%) | 14 (66.7%) |
P=0.064 |
| Intensive care unit treatment during the first 30 days of hospitalization + | 41 (17%) | 7 (33.3%) | |
| Male | 165 (68.5%) | 7 (33.3%) | P=0.87 |
| Female | 76 (31.5%) | 14 (66.7%) |
Epidemiological characteristics of children and adolescents with lymphomas
We took only sVTE as the event, data of asymptomatic VTE was censored. Patients were followed since the start of treatment to sVTE, relapse, death, +100 day after allogenic hematopoietic stem cell transplantation or loss to follow-up, whatever came. VTE diagnosed before the start of the treatment was recorded as the time 0. The median time of follow up was 2,18 years (IQR 0,71-3,85 years). Risk factors were analyzed by univariate and multivariate analysis with logistic regression. ROC-analysis was used for the determination of optimal cutoff. P-value <0,05 was considered as significant.
Results: Among all patients sVTE was diagnosed in 21 (8%, 95%CI: 4,73-11,3). Median time to diagnosis was 22 (IQR 17-36,5) days. The optimal cutoff for duration of treatment in the intensive care unit during the first 30 days was >2 days. The optimal cutoff for the volume of mediastinal lymphadenopathy was 250 ml. The optimal cutoff for age was ≥12 years. Results of the univariate and multivariate analysis are presented in the table 2.
| Characteristic | Univariate analysis | Multivariate analysis | ||
| Odds ratio (95%CI) | p-value | Odds ratio (95%CI) | p-value | |
| ABO group “Non-O” | 3.2 (0.925-11.28) | 0.066 | 4.86 (1.26-18.65) | 0.02 |
| Volume of mediastinal lymphadenopathy ≥250 ml | 6.3 (2.49-16.1) | 0.0001 | 4.38 (1.59-12.1) | 0.004 |
| ICU hospitalization ≥2 days | 3.6 (1.4-9.8) | 0.01 | 2.92 (0.98-8.68) | 0.053 |
| Age ≥12 years | 8.8 (2.5-30.8) | 0.001 | 6.7 (1.8-24.9) | 0.004 |
Univariate and multivariate analysis of risk factors for sVTE in children and adolescents with lymphomas.
Conclusions: Blood group “Non-O”, volume of mediastinal lymphadenopathy ≥250 ml and age ≥12 years are independent risk factors for sVTE in children and adolescents with lymphomas. These factors could be used for further studies of primary antithrombotic prophylaxis in this cohort of patients.
To cite this abstract in AMA style:
Evstratov D, Zharkov P, Myakova N. Risk Factors for Symptomatic Venous Thromboembolism in Children and Adolescents with Lymphomas [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/risk-factors-for-symptomatic-venous-thromboembolism-in-children-and-adolescents-with-lymphomas-2/. Accessed May 20, 2022.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/risk-factors-for-symptomatic-venous-thromboembolism-in-children-and-adolescents-with-lymphomas-2/