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Thromboembolism in children with cancer: a retrospective multicenter study in Korea

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Abstract

Thromboembolism (TE) is a major cause of morbidity and mortality in adult cancer patients; however, there is a lack of sufficient knowledge on TE in pediatric cancer patients. We aimed to determine the epidemiology of TE in Korean children with cancer. Between January 2000 and July 2015, we retrospectively analyzed pediatric patients newly diagnosed with cancer at six tertiary hospitals in Korea. Of 3611 children with cancer, 33 (0.91%) had TE. A higher number of patients with acute lymphoblastic leukemia (n = 13), brain tumors (n = 6), lymphoma (n = 4), and bone/soft tissue sarcomas (n = 5) tended to develop TE. The male/female ratio was 17/16, and the median age at TE diagnosis was 10 years and 2 months. TE was detected a median of 2 months after cancer diagnosis. Symptoms including pain and swelling were present in 18 of the 33 patients. In terms of location, three intracerebral, 23 upper venous, six lower venous and one combined upper and lower venous system TEs were observed. Additional risk factors for TE included central venous catheter (CVC) use in 12 patients, steroid and/or L-asparaginase use in nine, and CVC and steroid and/or L-asparaginase use in seven. The TE incidence rate was quite low among Korean children with cancer, but higher than in the general pediatric population and among children hospitalized for diseases other than cancer. Further investigation of a larger pool of patients is warranted to determine the most effective strategies to prevent and treat TE in Korean children with cancer.

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Abbreviations

ALL:

Acute lymphoblastic leukemia

AML:

Acute myeloid leukemia

AT III:

Antithrombin III

ATE:

Arterial thromboembolism

CNS:

Central nervous system

CT:

Computed tomography

CVC:

Central venous catheter

LMWH:

Low-molecular-weight heparin

MRI:

Magnetic resonance imaging

UFH:

Unfractionated heparin

TE:

Thromboembolism

VTE:

Venous thromboembolism

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Acknowledgements

This study was supported by a grant from the Seoul National University Bundang Hospital (SNUBH) Research Fund (Grant No.: 02-2013-047).

Author information

Author notes

  1. Kyung Duk Park

    Present address: Department of Pediatrics, Chonbuk National University Medical School, 20, Geonjiro Deokjin-gu, 54907, Jeonju, Jeollabuk-do, Republic of Korea

Authors and Affiliations

  1. Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Hyoung Soo Choi & Hye Jin Kim

  2. Department of Pediatrics, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea

    Hyoung Jin Kang, Ji Won Lee, Hee Young Shin & Kyung Duk Park

  3. Center for Pediatric Cancer, National Cancer Center, Goyang, Republic of Korea

    Hyeon Jin Park & Byung-Kiu Park

  4. Department of Pediatrics, Hanyang University Hospital, Seoul, Republic of Korea

    Young Ho Lee

  5. Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Republic of Korea

    Jun Ah Lee

  6. Department of Pediatrics, Chungnam National University Hospital, Daejeon, Republic of Korea

    Yeon-Jung Lim

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  1. Hyoung Soo Choi
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Correspondence to Kyung Duk Park.

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Ethical approval

This study was approved by the Institutional Review Board of each participating institution and the Seoul National University Bundang Hospital (SNUBH) (IRB Approval No. B-1308/214-112). The need to obtain informed consent was waived by the board.

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Choi, H.S., Kim, H.J., Kang, H.J. et al. Thromboembolism in children with cancer: a retrospective multicenter study in Korea. J Thromb Thrombolysis 47, 558–565 (2019). https://doi.org/10.1007/s11239-019-01808-x

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