Abstract Number: OC 08.3
Meeting: ISTH 2022 Congress
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.
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.
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