1.Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese Children's Cancer Group-ALL-2015.
Mengmeng YIN ; Hongsheng WANG ; Xianmin GUAN ; Ju GAO ; Minghua YANG ; Ningling WANG ; Tianfeng LIU ; Jingyan TANG ; Alex W K LEUNG ; Fen ZHOU ; Xuedong WU ; Jie HUANG ; Hong LI ; Shaoyan HU ; Xin TIAN ; Hua JIANG ; Jiaoyang CAI ; Xiaowen ZHAI ; Shuhong SHEN ; Qun HU
Frontiers of Medicine 2023;17(3):518-526
Venous thromboembolism (VTE) is a complication in children with acute lymphoblastic leukemia (ALL). The Chinese Children's Cancer Group-ALL-2015 protocol was carried out in China, and epidemiology, clinical characteristics, and risk factors associated with VTE were analyzed. We collected data on VTE in a multi-institutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December 2019. First, VTE occurred in 159 (2.08%) patients, including 90 (56.6%) during induction therapy and 108 (67.92%) in the upper extremities. T-ALL had a 1.74-fold increased risk of VTE (95% CI 1.08-2.8, P = 0.022). Septicemia, as an adverse event of ALL treatment, can significantly promote the occurrence of VTE (P < 0.001). Catheter-related thrombosis (CRT) accounted for 75.47% (n = 120); and, symptomatic VTE, 58.49% (n = 93), which was more common in patients aged 12-18 years (P = 0.023), non-CRT patients (P < 0.001), or patients with cerebral thrombosis (P < 0.001). Of the patients with VTE treated with anticoagulation therapy (n = 147), 4.08% (n = 6) had bleeding. The VTE recurrence rate was 5.03% (n = 8). Patients with VTE treated by non-ultrasound-guided venous cannulation (P = 0.02), with residual thrombus (P = 0.006), or with short anticoagulation period (P = 0.026) had high recurrence rates. Thus, preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.
Humans
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Child
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Venous Thromboembolism/etiology*
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East Asian People
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Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology*
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Risk Factors
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Thrombosis/chemically induced*
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China/epidemiology*
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Anticoagulants/adverse effects*
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Recurrence
Result Analysis
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