Venous Thromboembolism and Its Risk Factors in Children with Acute Lymphoblastic Leukemia in Israel: A Population-Based Study

Cancers

卷:12

Sigal Weinreb¹  Nira Arad-Cohen²  Shlomit Barzilai-Birenboim³  Shai Izraeli³  Galia Avrahami³  Sarah Elitzur³  Gil Gilad³  Miri Ben Harush⁴  Ronit Nirel⁵  Ronit Elhasid⁶  Amos Toren⁶  Bella Bielorai⁶  AssafArie Barg⁶ 

[1] Department of Pediatric Hematology-Oncology, Hadassah Hebrew University Medical Center, Jerusalem 9112102, Israel;

[2] Department of Pediatric Hematology-Oncology, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Technion-Israel Institute of Technology, Haifa 3109601, Israel;

[3] Department of Pediatric Hematology-Oncology, Schneider Children’s Medical Center of Israel, Petach Tikva 49202, Israel;

[4] Department of Pediatric Hematology-Oncology, Soroka Medical Center, Ben Gurion University, Beer Sheva 84990, Israel;

[5] Department of Statistics and Data Science, Hebrew University, Jerusalem 9190501, Israel;

[6] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;

关键词: acute lymphoblastic leukemia;    venous thromboembolism;    sinus vein thrombosis;    hypertriglyceridemia;    thrombophilia;    risk factors;   

DOI  :  10.3390/cancers12102759

来源: DOAJ

【 摘 要 】

Venous thromboembolism (VTE) is a serious complication of acute lymphoblastic leukemia (ALL) therapy. The aim of this population-based study was to evaluate the rate, risk factors, and long-term sequelae of VTE in children treated for ALL. The cohort included 1191 children aged 1–19 years diagnosed with ALL between 2003–2018, prospectively enrolled in two consecutive protocols: ALL-IC BFM 2002 and AIEOP-BFM ALL 2009. VTEs occurred in 89 patients (7.5%). Long-term sequelae were uncommon. By univariate analysis, we identified four significant risk factors for VTEs: Severe hypertriglyceridemia (p = 0.005), inherited thrombophilia (p < 0.001), age >10 years (p = 0.015), and high-risk ALL group (p = 0.039). In addition, the incidence of VTE was significantly higher in patients enrolled in AIEOP-BFM ALL 2009 than in those enrolled in ALL-IC BFM 2002 (p = 0.001). Severe VTE occurred in 24 children (2%), all of whom had at least one risk factor. Elevated triglyceride levels at diagnosis did not predict hypertriglyceridemia during therapy. In a multivariate analysis of 388 children, severe hypertriglyceridemia and inherited thrombophilia were independent risk factors for VTE. Routine evaluation for these risk factors in children treated for ALL may help identify candidates for intervention.

【 授权许可】

Unknown