Pediatr Blood Cancer. 2021 Dec 28;e29522. doi: 10.1002/pbc.29522. Epub 2021 Dec 28.
Markers of hypercoagulability in children with newly diagnosed acute lymphoblastic leukemia.
Pediatric blood & cancer
Roxana Carmona, Hande Kizilocak, Elizabeth Marquez-Casas, Siobhan Vasquez, Lingyun Ji, Richard H Ko, Guy Young, Julie Jaffray
Affiliations
Affiliations
- Hemostasis and Thrombosis Center, Children's Hospital Los Angeles, Los Angeles, California, USA.
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
PMID: 34963026
DOI: 10.1002/pbc.29522
Abstract
BACKGROUND: Venous thromboembolism (VTE) is a known complication for children with acute lymphoblastic leukemia (ALL). The aim of this study was to identify laboratory biomarkers that predict which children with ALL are at risk for VTE during induction chemotherapy.
MATERIALS AND METHODS: Newly diagnosed ALL patients admitted to Children's Hospital Los Angeles with a central venous catheter (CVC) were eligible to participate. Participants' blood samples (complete blood count [CBC], quantitative D-dimer, prothrombin fragment 1.2 [PTF 1.2], and thrombin-antithrombin complexes [TAT]) were collected at day 0 (baseline/prior to induction), day 7 (±2 days), day 14 (±2 days), day 21 (±2 days), and day 28 (±2 days) of induction chemotherapy or until participants presented with a symptomatic VTE.
RESULTS: Seventy-five participants aged 1-21 years were enrolled and included in the final analysis. Twenty-six (35%) of the 75 participants were diagnosed with a CVC-associated VTE (22 asymptomatic and four symptomatic). There was a statistically significant difference between VTE and non-VTE participants for D-dimer (odds ratio [OR] 1.61, 95% confidence interval [CI]: 1.59-1.64), TAT (OR 1.34, 95% CI: 1.32-1.38), and PTF 1.2 (OR 1.31, 95% CI: 1.25-1.37) at all time points. Participants >10 years had a significantly higher risk of developing a VTE compared to participants <4 years (p = .007).
CONCLUSION: Older children with ALL as well as those with an elevated TAT, PTF 1.2, or D-dimer showed an increased risk of VTE, which may hold potential for predicting VTE in future studies.
© 2021 Wiley Periodicals LLC.
Keywords: acute lymphoblastic leukemia; hypercoagulability; pediatrics; venous thromboembolism
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