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Venous Thromboembolism and Its Risk Factors in Children with Acute Lymphoblastic Leukemia in Israel: A

Shlomit Barzilai-Birenboim1,2, Ronit Nirel3, Nira Arad-Cohen4

  • 1Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva 49202, Israel.

Cancers
|September 30, 2020
PubMed

Insights

Venous thromboembolism (VTE) affects 7.5% of children with acute lymphoblastic leukemia (ALL). Severe hypertriglyceridemia and inherited thrombophilia are key risk factors for VTE in these young patients.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Thrombosis Research

Background:

  • Venous thromboembolism (VTE) is a significant complication in pediatric acute lymphoblastic leukemia (ALL) treatment.
  • Understanding VTE's incidence, risk factors, and outcomes is crucial for improving patient care.

Purpose of the Study:

  • To determine the rate, identify risk factors, and assess long-term sequelae of VTE in children undergoing ALL therapy.
  • To analyze the impact of treatment protocols on VTE incidence.

Main Methods:

  • Population-based cohort study of 1191 children (aged 1-19) diagnosed with ALL between 2003-2018.
  • Prospective enrollment in two consecutive treatment protocols (ALL-IC BFM 2002 and AIEOP-BFM ALL 2009).
  • Univariate and multivariate analyses to identify VTE risk factors and assess outcomes.

Main Results:

  • VTE occurred in 7.5% of patients; severe VTE in 2%.
  • Significant univariate risk factors included severe hypertriglyceridemia, inherited thrombophilia, older age, and high-risk ALL.
  • Multivariate analysis identified severe hypertriglyceridemia and inherited thrombophilia as independent VTE risk factors.
  • Higher VTE incidence was observed in the AIEOP-BFM ALL 2009 protocol compared to ALL-IC BFM 2002.

Conclusions:

  • Severe hypertriglyceridemia and inherited thrombophilia are independent risk factors for VTE in children with ALL.
  • Routine screening for these risk factors may aid in identifying children who could benefit from preventative interventions.
  • Long-term sequelae of VTE in this cohort were infrequent.

Keywords:
acute lymphoblastic leukemiahypertriglyceridemiarisk factorssinus vein thrombosisthrombophiliavenous thromboembolism

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