Abstract
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.
Original language | American English |
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Article number | 2759 |
Pages (from-to) | 1-15 |
Number of pages | 15 |
Journal | Cancers |
Volume | 12 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2020 |
Bibliographical note
Funding Information:Funding: This research was supported by the Israeli Society of Pediatric Hematology–Oncology, the Israel Cancer Association, and Amutat Chaim.
Funding Information:
This research was supported by the Israeli Society of Pediatric Hematology?Oncology, the Israel Cancer Association, and Amutat Chaim.The authors wish to acknowledge all pediatric hematology?oncology departments in Israel for their devoted care of these patients. Special thanks to Naomi Litichever and Dina Kugel, the data coordinators of the Israel National Study of Childhood ALL for their invaluable work, to Reut Rosen and Tali Shapiro of the Hebrew University for their help with the statistical analyses, and to Gloria Ganzach for her editing.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords
- Acute lymphoblastic leukemia
- Hypertriglyceridemia
- Risk factors
- Sinus vein thrombosis
- Thrombophilia
- Venous thromboembolism