Annals of Hematology

, Volume 97, Issue 10, pp 1903–1908 | Cite as

The association of venous thromboembolism with survival in pediatric cancer patients: a population-based cohort study

  • Zara Forbrigger
  • Stefan Kuhle
  • Mary Margaret Brown
  • Paul C. Moorehead
  • Carol Digout
  • Ketan KulkarniEmail author
Original Article


Venous thromboembolism (VTE) is a well-recognized complication in pediatric oncology patients. Studies in adult oncology patients have suggested a potential negative association between VTE and survival, but this association has not been examined in pediatric patients yet. The aim of this study was to assess the association of VTE with survival in pediatric oncology patients. Data from all pediatric oncology patients treated at the two tertiary care centers in Atlantic Canada were pooled to create a population-based cohort. The association between VTE and survival was analyzed using a Cox proportional hazards model stratified by diagnosis group (leukemia, lymphoma, and other; sarcoma) and adjusted for age at diagnosis and sex. Out of 939 patients included in this study, 73 had a VTE (8%) and 131 (14%) patients died during the study period. Children in the leukemia/lymphoma/other group with a VTE had significantly poorer survival relative to children in the same group who did not have a VTE. Although children with sarcoma and VTE had poorer survival compared to children with sarcoma with no VTE, this association was not statistically significant. In this population-based study, we found a negative association between VTE and survival in pediatric oncology patients. If future studies confirm this association, this finding may have prognostic implications and potentially offer new avenues for the management of pediatric patients with cancer.


Pediatric oncology Population-based Survival Venous thromboembolism 



The authors would like to acknowledge Stephanie Eason and Katherine Bowes for her work collecting the data on the patients treated at the Janeway Children’s Health and Rehabilitation Centre.

Funding information

This work was supported by the MacKinnon fund at the IWK Health Centre and the Janeway Children’s Health and Rehabilitation Centre’s Hematology/Oncology department.

Compliance with ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975 and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.


The need for consent for this retrospective study was waived due to impracticability as per the Nova Scotia Personal Health Information Act.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018
corrected publication June/2018

Authors and Affiliations

  1. 1.Department of PediatricsDivision of Hematology/Oncology, IWK Health CentreHalifaxCanada
  2. 2.Perinatal Epidemiology Research Unit, Departments of Pediatrics and Obstetrics & GynaecologyDalhousie UniversityHalifaxCanada
  3. 3.Pediatric Hematology/Oncology, Faculty of Medicine, Janeway Pediatric Research UnitJaneway Children’s Health and Rehabilitation Centre, Memorial UniversitySt. John’sCanada

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