Risk factors for symptomatic venous thromboembolism during therapy for childhood acute lymphoblastic leukemia.

Mateos, MK; Trahair, TN; Mayoh, C; Barbaro, PM; Sutton, R; Revesz, T; Barbaric, D; Giles, JE; Alvaro, F; Mechinaud, F; Catchpoole, D; Kotecha, RS; Dalla-Pozza, L; Quinn, MCJ; MacGregor, S; Chenevix-Trench, G; Marshall, GM

Risk factors for symptomatic venous thromboembolism during therapy for childhood acute lymphoblastic leukemia.

Mateos, MK Trahair, TN Mayoh, C Barbaro, PM Sutton, R Revesz, T Barbaric, D Giles, JE Alvaro, F Mechinaud, F Catchpoole, D Kotecha, RS Dalla-Pozza, L Quinn, MCJ MacGregor, S Chenevix-Trench, G Marshall, GM

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Thrombosis research, 2019, 178, pp. 132-138
Issue Date:: 2019-06

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Field	Value	Language
dc.contributor.author	Mateos, MK
dc.contributor.author	Trahair, TN
dc.contributor.author	Mayoh, C
dc.contributor.author	Barbaro, PM
dc.contributor.author	Sutton, R
dc.contributor.author	Revesz, T
dc.contributor.author	Barbaric, D
dc.contributor.author	Giles, JE
dc.contributor.author	Alvaro, F
dc.contributor.author	Mechinaud, F
dc.contributor.author	Catchpoole, D
dc.contributor.author	Kotecha, RS
dc.contributor.author	Dalla-Pozza, L
dc.contributor.author	Quinn, MCJ
dc.contributor.author	MacGregor, S
dc.contributor.author	Chenevix-Trench, G
dc.contributor.author	Marshall, GM
dc.date.accessioned	2020-05-14T06:23:26Z
dc.date.available	2019-04-10
dc.date.available	2020-05-14T06:23:26Z
dc.date.issued	2019-06
dc.identifier.citation	Thrombosis research, 2019, 178, pp. 132-138
dc.identifier.issn	0049-3848
dc.identifier.issn	1879-2472
dc.identifier.uri	http://hdl.handle.net/10453/140717
dc.description.abstract	BACKGROUND:Symptomatic venous thromboembolism (VTE) is an unpredictable and life-threatening toxicity, which occurs early in childhood acute lymphoblastic leukemia (ALL) therapy. Approximately 5% of children will experience VTE which is treated with anticoagulation. Asparaginase and corticosteroids are etiologic factors for VTE, however other clinical factors may modify this risk. PROCEDURE:We sought to i) assess published pre-treatment VTE risk factors ii) identify early clinical factors that were associated with VTE and iii) determine whether single nucleotide polymorphisms (SNPs) associated with VTE in non-cancer patients contributed to VTE in children with ALL. We performed a detailed, retrospective analysis of 1021 ALL patients treated between 1998 and 2013. Individual patient records were reviewed to ascertain VTE incidence and document treatment-related clinical variables. RESULTS:The incidence of VTE was 5.1%. Extremes of weight at diagnosis (<5th or >95th centile) was an independent risk factor in multivariable analysis, when added to published risk factors of age ≥10 years and mediastinal mass. When factors during induction/consolidation were considered separately: bacteremia, elevated serum gamma-glutamyl transferase and bilirubin were associated with VTE occurrence. None of the SNPs associated with VTE in non-cancer populations were significantly associated with VTE in our cohort. CONCLUSION:We found two known risk factors (age ≥ 10 years and mediastinal mass) in a large cohort of children treated for ALL and identified other factors associated with VTE such as weight extremes at diagnosis, bacteremia, and abnormal liver function which warrant further study. These VTE risk factors may form the basis of future thromboprophylaxis trials.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	Thrombosis research
dc.relation.isbasedon	10.1016/j.thromres.2019.04.011
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1103 Clinical Sciences
dc.subject.classification	Cardiovascular System & Hematology
dc.subject.mesh	Humans
dc.subject.mesh	Risk Factors
dc.subject.mesh	Polymorphism, Single Nucleotide
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Infant
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Precursor Cell Lymphoblastic Leukemia-Lymphoma
dc.subject.mesh	Venous Thromboembolism
dc.subject.mesh	Humans
dc.subject.mesh	Risk Factors
dc.subject.mesh	Polymorphism, Single Nucleotide
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Infant
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Precursor Cell Lymphoblastic Leukemia-Lymphoma
dc.subject.mesh	Venous Thromboembolism
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Male
dc.subject.mesh	Polymorphism, Single Nucleotide
dc.subject.mesh	Precursor Cell Lymphoblastic Leukemia-Lymphoma
dc.subject.mesh	Risk Factors
dc.subject.mesh	Venous Thromboembolism
dc.title	Risk factors for symptomatic venous thromboembolism during therapy for childhood acute lymphoblastic leukemia.
dc.type	Journal Article
utslib.citation.volume	178
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-05-14T06:23:21Z
pubs.publication-status	Published
pubs.volume	178
utslib.start-page	132

Abstract:

BACKGROUND:Symptomatic venous thromboembolism (VTE) is an unpredictable and life-threatening toxicity, which occurs early in childhood acute lymphoblastic leukemia (ALL) therapy. Approximately 5% of children will experience VTE which is treated with anticoagulation. Asparaginase and corticosteroids are etiologic factors for VTE, however other clinical factors may modify this risk. PROCEDURE:We sought to i) assess published pre-treatment VTE risk factors ii) identify early clinical factors that were associated with VTE and iii) determine whether single nucleotide polymorphisms (SNPs) associated with VTE in non-cancer patients contributed to VTE in children with ALL. We performed a detailed, retrospective analysis of 1021 ALL patients treated between 1998 and 2013. Individual patient records were reviewed to ascertain VTE incidence and document treatment-related clinical variables. RESULTS:The incidence of VTE was 5.1%. Extremes of weight at diagnosis (<5th or >95th centile) was an independent risk factor in multivariable analysis, when added to published risk factors of age ≥10 years and mediastinal mass. When factors during induction/consolidation were considered separately: bacteremia, elevated serum gamma-glutamyl transferase and bilirubin were associated with VTE occurrence. None of the SNPs associated with VTE in non-cancer populations were significantly associated with VTE in our cohort. CONCLUSION:We found two known risk factors (age ≥ 10 years and mediastinal mass) in a large cohort of children treated for ALL and identified other factors associated with VTE such as weight extremes at diagnosis, bacteremia, and abnormal liver function which warrant further study. These VTE risk factors may form the basis of future thromboprophylaxis trials.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/140717