Incidence and Management of Thromboembolism in Patients with Acute Leukemia.
Salih GülerAytül TemuroğluMelike Sezgin EvimAdalet Meral GüneşPublished in: Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion (2023)
Thromboembolic events (TE) in childhood are relatively rare but, serious complications of acute leukemia. The aim was to define the incidence and risk factors of thrombosis in children with leukemias. The electronic files of pediatric denovo/relapsed acute leukemia patients aged below 18 years, treated between 2011 and 2021 were retrospectively evaluated for thrombotic attacks. Thirty out of 469 patients developed 35 thrombotic events. The median age at the time of the TE was 11.8 (2-17.6) years, and the median time from diagnosis to TE was 9 (0-58) months. The frequency of TE was found at 7.4% (n = 35/469). When catheter related (n = 13) events, superficial venous events (n = 10), and arterial central nervous system thrombosis (n = 1) were excluded, the frequency of TE was decreased to 2.3% (n = 11/469). Children older than 10 years old (13.8%; n = 21/152) had significantly higher thromboembolic events than the others (4.4%; n = 14/317) (p = 0.03). The majority of attacks were symptomatic 66% (n = 23/35). The most common complaints were local pain, swelling, and redness 52% (n = 12/23). The majority of attacks in patients with relapsed (75%; 6/8) and newly diagnosed acute lymphoblastic leukemia (40%; 10/25%) developed during the induction phase. Thrombosis recurred in 13.3% (n = 4/30) of cases more than once. Thrombotic attacks were successfully treated with low molecular weight heparin 60% (n = 21/35), and recombinant tissue plasminogen activator 17% (n = 6/35). None of the children were lost due to thrombosis. Thrombosis is an important complication during acute leukemia treatment. Successful results are obtained with early diagnosis and treatment attempts by creating awareness.
Keyphrases
- ejection fraction
- acute lymphoblastic leukemia
- pulmonary embolism
- newly diagnosed
- young adults
- acute myeloid leukemia
- diffuse large b cell lymphoma
- physical activity
- risk factors
- multiple myeloma
- end stage renal disease
- chronic kidney disease
- chronic pain
- hodgkin lymphoma
- spinal cord injury
- pain management
- neuropathic pain
- combination therapy
- ultrasound guided
- patient reported outcomes
- cell free