Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese Children's Cancer Group-ALL-2015

作者全名："Yin, Mengmeng; Wang, Hongsheng; Guan, Xianmin; Gao, Ju; Yang, Minghua; Wang, Ningling; Liu, Tianfeng; Tang, Jingyan; Leung, Alex W. K.; Zhou, Fen; Wu, Xuedong; Huang, Jie; Li, Hong; Hu, Shaoyan; Tian, Xin; Jiang, Hua; Cai, Jiaoyang; Zhai, Xiaowen; Shen, Shuhong; Hu, Qun"

作者地址："[Yin, Mengmeng; Hu, Qun] Huazhong Univ Sci & Technol, Tongji Hosp, Dept Pediat, Tongji Med Coll, Wuhan 430030, Peoples R China; [Wang, Hongsheng; Zhai, Xiaowen] Fudan Univ, Dept Hematol Oncol, Childrens Hosp, Shanghai 201100, Peoples R China; [Tang, Jingyan; Cai, Jiaoyang; Shen, Shuhong] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Sch Med, Dept Hematol Oncol,Key Lab Pediat Hematol & Oncol,, Shanghai 200120, Peoples R China; [Guan, Xianmin] Chongqing Med Univ, Dept Hematol Oncol, Affiliated Childrens Hosp, Chongqing 400015, Peoples R China; [Gao, Ju] Sichuan Univ, West China Univ Hosp 2, Dept Pediat, Key Lab Birth Defects & Related Dis Women & Childr, Chengdu 610041, Peoples R China; [Yang, Minghua] Cent South Univ, Dept Pediat, Xiangya Hosp, Changsha 410008, Peoples R China; [Wang, Ningling] Anhui Med Univ, Dept Pediat, Affiliated Hosp 2, Hefei 230601, Peoples R China; [Liu, Tianfeng] Chinese Acad Med Sci, Inst Hematol & Blood Dis Hosp, Peking Union Med Coll, State Key Lab Expt Hematol, Tianjin 300020, Peoples R China; [Liu, Tianfeng] Chinese Acad Med Sci, Peking Union Med Coll, Inst Hematol & Blood Dis Hosp, Div Pediat Blood Dis Ctr, Tianjin 300020, Peoples R China; Chinese Univ Hong Kong, Hong Kong Childrens Hosp, Dept Pediat, Hong Kong 999077, Peoples R China; [Zhou, Fen] Huazhong Univ Sci & Technol, Union Hosp, Dept Pediat, Tongji Med Coll, Wuhan 430022, Peoples R China; [Wu, Xuedong] Southern Med Univ, Nanfang Hosp, Dept Pediat, Guangzhou 516006, Peoples R China; [Huang, Jie] Nanjing Med Univ, Dept Hematol Oncol, Childrens Hosp, Nanjing 210008, Peoples R China; [Li, Hong] Shanghai Jiao Tong Univ, Shanghai Childrens Hosp, Dept Hematol Oncol, Shanghai 200062, Peoples R China; [Hu, Shaoyan] Soochow Univ, Dept Hematol Oncol, Childrens Hosp, Suzhou 215002, Peoples R China; [Tian, Xin] Kunming Childrens Hosp, Dept Hematol Oncol, Kunming 650103, Peoples R China"

通信作者："Hu, Q (通讯作者)，Huazhong Univ Sci & Technol, Tongji Hosp, Dept Pediat, Tongji Med Coll, Wuhan 430030, Peoples R China.; Zhai, XW (通讯作者)，Fudan Univ, Dept Hematol Oncol, Childrens Hosp, Shanghai 201100, Peoples R China.; Shen, SH (通讯作者)，Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Sch Med, Dept Hematol Oncol,Key Lab Pediat Hematol & Oncol,, Shanghai 200120, Peoples R China."

来源：FRONTIERS OF MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000937618200001

JCR分区：Q2

影响因子：3.9

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：acute lymphoblastic leukemia; child; venous thromboembolism; epidemiology; clinical characteristic; risk factor

摘要："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."

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