CVC not independent risk factor for thromboembolism in children
Venous thromboembolism (VTE) is a well-known complication of the treatment of pediatric acute lymphoblastic leukemia (ALL). We analyzed 1026 ALL patients 1-18-years-old, who were enrolled into the AIEOP-BFM ALL 2000 or 2009 studies in Austria, with regard to the incidence and risk factors of VTE. The 2.5-year cumulative incidence (CI) of VTE ≥ grade 2 was 4%±1% (n = 36/1026). Twenty VTE (56%) were found in the central nervous system (19 cerebral venous sinus and 1 cortical vein thrombosis), and 16 (44%) at other sites (7 deep vein thromboses (DVT) of the lower extremity, 4 DVT of the upper extremity, 4 central venous line-thromboses, 1 pulmonary embolism). Most VTE occurred during induction and early consolidation therapy (81%) and were associated with L-asparaginase within 4 and corticosteroids withing 1 week(s) preceding the event (89 and 86%, respectively). In multivariable analysis, two independent risk factors were found. Patients 10-18-years-old had an increased (hazard-ratio: 2.156, p = 0.0389), whereas treatments in trial AIEOP-BFM ALL 2009 had a lower risk for VTE (hazard-ratio: 0.349, p = 0.0270). In conclusion, the 2.5-year CI of VTE among our pediatric patient cohort was <5% and adolescent age was the main patient-related risk factor. This older age group might benefit from primary prophylactic measures.
Gidl A, Füreder A, Benesch M, Dworzak M, Engstler G, Jones N, Kropshofer G, Pötschger U, Poyer F, Tamesberger M, Witt V, Mann G, Attarbaschi A; Austrian Berlin-Frankfurt-Münster (BFM) Study Group. Incidence and Risk Factors of Venous Thromboembolism in Childhood Acute Lymphoblastic Leukaemia – a Population-Based Analysis of the Austrian Berlin-Frankfurt-Münster (BFM) Study Group. Pediatr Hematol Oncol. 2022 Jul 18:1-11. doi: 10.1080/08880018.2022.2089791. Epub ahead of print. PMID: 35848787.