Show simple item record

dc.contributor.authorTuckuviene, Ren
dc.contributor.authorRanta, Sen
dc.contributor.authorAlbertsen, B Ken
dc.contributor.authorAndersson, N Gen
dc.contributor.authorBendtsen, M Den
dc.contributor.authorFrisk, Ten
dc.contributor.authorGunnes, M Wen
dc.contributor.authorHelgestad, Jen
dc.contributor.authorHeyman, M Men
dc.contributor.authorJonsson, O Gen
dc.contributor.authorMäkipernaa, Aen
dc.contributor.authorPruunsild, Ken
dc.contributor.authorTedgård, Uen
dc.contributor.authorTrakymiene, S Sen
dc.contributor.authorRuud, Een
dc.date.accessioned2016-05-03T14:24:14Zen
dc.date.available2016-05-03T14:24:14Zen
dc.date.issued2016-03en
dc.date.submitted2016en
dc.identifier.citationThromb. Haemost. 2016, 14 (3):485-94 J.en
dc.identifier.issn1538-7836en
dc.identifier.pmid26707629en
dc.identifier.doi10.1111/jth.13236en
dc.identifier.urihttp://hdl.handle.net/2336/607770en
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.abstractBackground Thromboembolism (TE) is a major toxicity in children with acute lymphoblastic leukemia (ALL) and may have a negative impact on ALL treatment. Objectives To examine the cumulative incidence, outcomes and risk factors associated with TE in children with leukemia. Patients/Methods We prospectively evaluated TE in 1038 Nordic children and adolescents (≥ 1 and < 18 years) diagnosed with ALL during 2008-2013 and treated according to the NOPHO (Nordic Society of Pediatric Hematology and Oncology)-ALL 2008 protocol. The cohort was followed until December 2014. Cox proportional regression was used to compute hazard ratios (HRs). Results TE events (n = 63) occurred most frequently in conjunction with asparaginase (ASP) administration (52/63). The cumulative incidence of TE was 6.1% (95% confidence interval [CI], 4.8-7.7). Being aged 15-17 years was associated with an increased risk of TE (adjusted HR of 4.0; 95% CI, 2.1-7.7). We found a TE-associated 30-day case fatality of 6.4% (95% CI, 1.8-15.5) and TE-related truncation of ASP therapy in 36.2% (21/58). Major hemorrhage occurred in 3.5% (2/58) of anticoagulated patients. Minor hemorrhage was reported in two out of 58 patients. No major bleeds occurred in children who received low-molecular-weight heparin. Conclusions Methods to identify children and adolescents who will benefit from thromboprophylaxis during ALL treatment are called for. The truncation of ASP should be avoided. The long-term survival outcomes for ALL patients with TE require close monitoring in the future.
dc.language.isoenen
dc.publisherWiley-Blackwellen
dc.relation.urlhttp://dx.doi.org/ 10.1111/jth.13236en
dc.rightsArchived with thanks to Journal of thrombosis and haemostasis : JTHen
dc.subjectPED12
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphomaen
dc.subject.meshAsparaginaseen
dc.subject.meshThromboembolismen
dc.subject.meshChild, Preschoolen
dc.subject.meshChilden
dc.titleProspective study of thromboembolism in 1038 children with acute lymphoblastic leukemia: a Nordic Society of Pediatric Hematology and Oncology (NOPHO) study.en
dc.typeArticleen
dc.contributor.department[ 1 ] Aalborg Univ Hosp, Dept Pediat, DK-9000 Aalborg, Denmark [ 2 ] Karolinska Univ Hosp, Childhood Canc Res Unit, Dept Womens & Childrens Hlth, Stockholm, Sweden [ 3 ] Karolinska Inst, Stockholm, Sweden [ 4 ] Aarhus Univ Hosp, Dept Pediat, DK-8000 Aarhus, Denmark [ 5 ] Lund Univ, Malmo Univ Hosp, Dept Pediat, Malmo, Sweden [ 6 ] Lund Univ, Malmo Univ Hosp, Dept Coagulat Disorders, Malmo, Sweden [ 7 ] Aalborg Univ, Dept Clin Med, Aalborg, Denmark [ 8 ] Haukeland Hosp, Dept Pediat, N-5021 Bergen, Norway [ 9 ] Landspitali Univ Hosp, Childrens Hosp, Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 10 ] Univ Helsinki, Childrens Hosp, Helsinki, Finland [ 11 ] Univ Helsinki, Cent Hosp, Ctr Canc, Dept Hematol, Helsinki, Finland [ 12 ] Tallinn Childrens Hosp, Dept Oncohematol, Tallinn, Estonia [ 13 ] Vilnius Univ Hosp Santariskiu Klin, Childrens Hosp, Ctr Pediat Oncol & Hematol, Vilnius, Lithuania [ 14 ] Oslo Univ Hosp, Rikshosp, Dept Pediat Med, Oslo, Norwayen
dc.identifier.journalJournal of thrombosis and haemostasis : JTHen
dc.rights.accessClosed - Lokaðen
html.description.abstractEssentials Children with acute lymphoblastic leukemia (ALL) are at risk of thromboembolism (TE). This is a prospective evaluation of the incidence, risk factors and outcomes of TE in 1038 children with ALL. TE occurred in 6.1% of children, with the highest incidence (20.5%) among those aged 15-17 years. A TE-associated case fatality of 6.4% indicates that TE is a severe complication of ALL treatment.
html.description.abstractBackground Thromboembolism (TE) is a major toxicity in children with acute lymphoblastic leukemia (ALL) and may have a negative impact on ALL treatment. Objectives To examine the cumulative incidence, outcomes and risk factors associated with TE in children with leukemia. Patients/Methods We prospectively evaluated TE in 1038 Nordic children and adolescents (≥ 1 and < 18 years) diagnosed with ALL during 2008-2013 and treated according to the NOPHO (Nordic Society of Pediatric Hematology and Oncology)-ALL 2008 protocol. The cohort was followed until December 2014. Cox proportional regression was used to compute hazard ratios (HRs). Results TE events (n = 63) occurred most frequently in conjunction with asparaginase (ASP) administration (52/63). The cumulative incidence of TE was 6.1% (95% confidence interval [CI], 4.8-7.7). Being aged 15-17 years was associated with an increased risk of TE (adjusted HR of 4.0; 95% CI, 2.1-7.7). We found a TE-associated 30-day case fatality of 6.4% (95% CI, 1.8-15.5) and TE-related truncation of ASP therapy in 36.2% (21/58). Major hemorrhage occurred in 3.5% (2/58) of anticoagulated patients. Minor hemorrhage was reported in two out of 58 patients. No major bleeds occurred in children who received low-molecular-weight heparin. Conclusions Methods to identify children and adolescents who will benefit from thromboprophylaxis during ALL treatment are called for. The truncation of ASP should be avoided. The long-term survival outcomes for ALL patients with TE require close monitoring in the future.


This item appears in the following Collection(s)

Show simple item record