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Thrombosis in children with hematologic malignancies

Rosemarie Schobess1, Beate Kempf-Bielack, Dirk Schwabe

  • 1Department of Pediatrics, University of Halle, Germany.

Reviews in Clinical and Experimental Hematology
|July 21, 2005
PubMed

Insights

Pediatric acute lymphoblastic leukemia patients with prothrombotic risk factors may develop venous thrombosis due to prednisone and E. coli asparaginase treatment. Preventive anticoagulant strategies are discussed.

Area of Science:

  • Pediatric Hematology
  • Oncology
  • Thrombosis Research

Background:

  • Symptomatic thrombosis is a concern in children with hematologic malignancies.
  • Acquired and inherited prothrombotic risk factors increase this risk.
  • Treatment protocols, including chemotherapy, interact with these risk factors.

Purpose of the Study:

  • To review pediatric reports on thrombosis in children with hematologic malignancies.
  • To discuss the interplay of treatment, risk factors, and thrombosis.
  • To suggest potential preventive strategies for thrombosis.

Main Methods:

  • Literature review of pediatric reports up to January 2004.
  • Analysis of symptomatic thrombosis cases in children with hematologic malignancies, primarily acute lymphoblastic leukemia.
  • Discussion of various prothrombotic risk factors (genetic and acquired) and treatment modalities.

Main Results:

  • Prednisone and E. coli asparaginase administered together appear to be a significant factor in venous thrombosis onset in leukemic patients with prothrombotic risk factors.
  • Interactions between treatment, study design, ethnicity, and central venous catheters are considered.
  • The review highlights the complexity of thrombosis development in this patient population.

Conclusions:

  • Concomitant administration of prednisone and E. coli asparaginase is implicated in the majority of venous thrombosis cases in pediatric leukemia patients with prothrombotic risk factors.
  • Primary preventive anticoagulant or antithrombotic strategies should be considered.
  • Further research into risk stratification and tailored preventive measures is warranted.

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