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Venous thromboembolism risk factors in pediatric patients with high-grade glioma: a multicenter retrospective study

Yanxia Chen1, Wenjing Fei2, Yaqin Shi1

  • 1Department of Neurosurgery, The 904th Hospital of PLA, Medical School of Anhui Medical University, Wuxi, China.

Frontiers in Pediatrics
|August 28, 2025
PubMed

Insights

Pediatric high-grade glioma patients have a high risk of venous thromboembolism (VTE). Factors like tumor characteristics and treatments influence VTE, which negatively impacts survival, necessitating targeted prevention strategies.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Neuro-oncology

Background:

  • Venous thromboembolism (VTE) is a critical complication in pediatric high-grade glioma (pHGG) patients.
  • Understanding unique pediatric risk factors for VTE is crucial for effective management.

Purpose of the Study:

  • To identify risk factors and clinical characteristics associated with VTE in pediatric high-grade glioma patients.
  • To analyze the impact of VTE on prognosis and survival in this population.

Main Methods:

  • A multicenter retrospective analysis of 168 pHGG patients (January 2012 - January 2024).
  • Data collected from electronic medical records, including VTE occurrence, clinical details, and outcomes.
  • Statistical analyses included t-tests, Mann-Whitney U-tests, chi-square, and Cox regression models.

Main Results:

  • 37.5% of patients experienced VTE.
  • Protective factors against VTE included anticoagulation, IDH1 mutations, MGMT methylation, radiotherapy, chemotherapy, and reduced bed rest.
  • Risk factors for VTE included increased tumor volume, Grade 4 glioma, EGFR positivity, p53 mutations, glucocorticoid therapy, and central venous catheter placement.
  • VTE occurrence was associated with a median survival of 51.4 months and negatively impacted prognosis.

Conclusions:

  • This study identifies key risk factors for VTE in pediatric high-grade glioma.
  • Tailored prevention and treatment strategies are essential for managing VTE and improving outcomes.
  • Clinical characteristics, genetic profiles, and treatment modalities are critical in VTE management for pHGG patients.
Abstract

Keywords:
anticoagulation therapypediatric high-grade gliomarisk factorssurvival outcomesvenous thromboembolism

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