Venous thromboembolism in a large series of pediatric patients with acute lymphoblastic leukemia. Risk factors and use of prophylaxis.

R. Berrueco¹, A. Ruiz-Llobet², S. Gassiot³, E. Sarrate⁴, J. Zubicaray⁵, J. Dapena⁶, A. Menárguez⁷, M. Panesso⁷, C. Montoya⁸, J. Vagace⁹, J. Molina¹⁰, M. García-Morín¹¹, M. García-Abos¹², M. Mendoza¹³, F. Lendinez¹⁴, P. Palomo¹⁵, M. Tallón¹⁶, B. González¹⁷, E. Urrutia¹⁸, J. Serna¹⁹

¹Hospital Sant Joan de Déu, Esplugues Llobregat, Catalonia, Spain, ²Hospital Sant Joan de Déu, Esplugues de Llobregat, Catalonia, Spain, ³Sant Joan de Déu Hospital, Esplugues de LLobregat, Catalonia, Spain, ⁴Sant Joan de Déu Hospital, Esplugues de Llobregat, Ceuta, Spain, ⁵Hospital Infantil Universitario Niño Jesús, Madrid, Madrid, Spain, ⁶Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain, ⁷Hospital Universitario Vall d'Hebrón, Barcelona, Catalonia, Spain, ⁸Hospital de Alicante, Alicante, Comunidad Valenciana, Spain, ⁹Complejo Hospitalario Universitario de Badajoz., Badajoz, Extremadura, Spain, ¹⁰Hospital Universitario Reina Sofía, Córdoba, Andalucia, Spain, ¹¹Hospital Gregorio Marañón, Madrid, Madrid, Spain, ¹²Hospital Universitario Donostia, Donostia, Pais Vasco, Spain, ¹³Hospital Universitario de Salamanca, Salamanca, Castilla y Leon, Spain, ¹⁴Hospital Torrecárdenas, Almería, Andalucia, Spain, ¹⁵Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain, ¹⁶Hospital Álvaro Cunquerio Vigo, Vigo, Galicia, Spain, ¹⁷Hospital Universitario La Paz, Madrid, Madrid, Spain, ¹⁸Hospital Materno Infantil Virgen de las Nieves, Granada, Andalucia, Spain, ¹⁹Hospital Sant Pau i la Santa Creu, Barcelona, Catalonia, Spain

Abstract Number: OC 08.3

Meeting: ISTH 2022 Congress

Theme: Pediatrics » Thrombosis in Neonates and Children

Background: Symptomatic venous thromboembolism (VTE) is diagnosed in 3-14% of patients during pediatric acute lymphoblastic leukemia (ALL) therapy. There are well-known risk factors, but the role of others as inherited thrombophilia is still controversial. Prophylaxis with low molecular weight heparin (LMWH) has been described, but its use is not globally accepted.

Aims: To evaluate VTE rate and VTE risk factors in ALL patients treated following the same protocol, and safety and effectiveness of LMWH administration as thromboprophylaxis in children with inherited thrombophilia.

Methods: A retrospective multicentric study in ALL patients 1-18 years old following SEHOP-PETHEMA-2013 treatment guideline was performed to evaluate VTE rate, anticoagulant treatment, outcome, risk factors, and safety and usefulness of LMWH administration as primary thromboprophylaxis in children with inherited thrombophilia.

Results: A total of 652 patients were included in the study. VTE incidence was 8.7%. Most of the cases occurred during induction therapy, associated to central venous catheter. Univariant analysis showed that family history of thrombosis, presence of mediastinal mass, high-risk treatment group and inherited thrombophilia were statistically significant risk factors. Inherited thrombophilia was also an independent risk VTE factor in multivariate analysis (figure 1). LMWH administration was related to a decrease of VTE in patients with inherited thrombophilia and those with T-ALL phenotype.

Conclusion(s): Most of VTE cases occurred in patients without inherited thrombophilia, but when it is present, VTE risk is higher. LMWH administration was useful to decrease VTE in these patients.

Figure

Thrombosis-free cumulative survival.

To cite this abstract in AMA style:

Berrueco R, Ruiz-Llobet A, Gassiot S, Sarrate E, Zubicaray J, Dapena J, Menárguez A, Panesso M, Montoya C, Vagace J, Molina J, García-Morín M, García-Abos M, Mendoza M, Lendinez F, Palomo P, Tallón M, González B, Urrutia E, Serna J. Venous thromboembolism in a large series of pediatric patients with acute lymphoblastic leukemia. Risk factors and use of prophylaxis. [abstract]. https://abstracts.isth.org/abstract/venous-thromboembolism-in-a-large-series-of-pediatric-patients-with-acute-lymphoblastic-leukemia-risk-factors-and-use-of-prophylaxis/. Accessed September 27, 2023.

« Back to ISTH 2022 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/venous-thromboembolism-in-a-large-series-of-pediatric-patients-with-acute-lymphoblastic-leukemia-risk-factors-and-use-of-prophylaxis/