Jessica Gartrell1,2, Sue C Kaste2,3, John T Sandlund1,2, Jamie Flerlage1,2, Yinmei Zhou4, Cheng Cheng4, Jeremie Estepp2,5, Monika L Metzger1,2. 1. Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee. 2. University of Tennessee Health Science Center, Memphis, Tennessee. 3. Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tennessee. 4. Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee. 5. Department of Hematology, St Jude Children's Research Hospital, Memphis, Tennessee.
Abstract
BACKGROUND: Children diagnosed with cancer are at a significantly higher risk of developing a thrombotic event (TE) compared with the general population. The rarity of these events makes it difficult to discern the specific risk factors; however, age, sex, presence of central venous lines, inherited thrombophilia, and mediastinal mass may play a role. The primary aim of this study is to identify prognostic characteristics of children diagnosed with non-lymphoblastic lymphomas associated with a greater risk of developing a TE early on in their disease, with an increased focus on mediastinal mass characteristics. METHODS: Retrospective chart review of pediatric patients diagnosed with non-lymphoblastic lymphoma between 2004 and 2014 at St. Jude Children's Research Hospital. RESULTS: TE occurred in 8.5% (n = 28/330) of individuals at a median of 21 days from the diagnosis of a non-lymphoblastic lymphoma, with 60% of TEs occurring within 30 days of diagnosis. Of the variables evaluated, only presence of a peripherally inserted central catheter (odds ratio [OR]: 3.14 [95% CI: 1.24-7.98; P = 0.02]) and degree of superior vena cava (SVC) compression of > 25% increased the odds of developing a TE (OR: 2.2 [95% CI: 1.01-4.93; P = 0.048]). CONCLUSION: Pediatric patients with non-lymphoblastic lymphoma are at increased risk of developing TEs. In contrast to previous studies, the presence of a mediastinal mass alone was not associated with a higher risk of TE, but individuals with a mediastinal mass with 25% or greater degree of SVC compression were more likely to develop a TE. This finding highlights a high-risk group of children who may benefit from prophylactic anticoagulation.
BACKGROUND:Children diagnosed with cancer are at a significantly higher risk of developing a thrombotic event (TE) compared with the general population. The rarity of these events makes it difficult to discern the specific risk factors; however, age, sex, presence of central venous lines, inherited thrombophilia, and mediastinal mass may play a role. The primary aim of this study is to identify prognostic characteristics of children diagnosed with non-lymphoblastic lymphomas associated with a greater risk of developing a TE early on in their disease, with an increased focus on mediastinal mass characteristics. METHODS: Retrospective chart review of pediatric patients diagnosed with non-lymphoblastic lymphoma between 2004 and 2014 at St. Jude Children's Research Hospital. RESULTS:TE occurred in 8.5% (n = 28/330) of individuals at a median of 21 days from the diagnosis of a non-lymphoblastic lymphoma, with 60% of TEs occurring within 30 days of diagnosis. Of the variables evaluated, only presence of a peripherally inserted central catheter (odds ratio [OR]: 3.14 [95% CI: 1.24-7.98; P = 0.02]) and degree of superior vena cava (SVC) compression of > 25% increased the odds of developing a TE (OR: 2.2 [95% CI: 1.01-4.93; P = 0.048]). CONCLUSION: Pediatric patients with non-lymphoblastic lymphoma are at increased risk of developing TEs. In contrast to previous studies, the presence of a mediastinal mass alone was not associated with a higher risk of TE, but individuals with a mediastinal mass with 25% or greater degree of SVC compression were more likely to develop a TE. This finding highlights a high-risk group of children who may benefit from prophylactic anticoagulation.
Authors: A Schönning; J Karlén; T Frisk; M Heyman; J E Svahn; I Øra; L Kawan; B-M Holmqvist; C Björklund; A Harila-Saari; S Ranta Journal: Thromb Res Date: 2017-02-16 Impact factor: 3.944
Authors: Ceder H van den Bosch; Judith Spijkerman; Marc H W A Wijnen; Idske C L Kremer Hovinga; Friederike A G Meyer-Wentrup; Alida F W van der Steeg; Marianne D van de Wetering; Marta Fiocco; Indra E Morsing; Auke Beishuizen Journal: Support Care Cancer Date: 2022-07-01 Impact factor: 3.359