Venous thromboembolism in children with acute lymphoblastic leukemia in China:a report from the Chinese Children’s Cancer Group-ALL-2015

查看全文 作　　者：Mengmeng [1]Yin;Hongsheng [2]Wang;Xianmin [4]Guan;Ju [5]Gao;Minghua [6]Yang;Ningling [7]Wang;Tianfeng [8]Liu;Jingyan [3]Tang;Alex WK [9]Leung;Fen [10]Zhou;Xuedong [11]Wu;Jie [12]Huang;Hong [13]Li;Shaoyan [14]Hu;Xin [15]Tian;Hua [16]Jiang;Jiaoyang [3]Cai;Xiaowen [2]Zhai;Shuhong [3]Shen;Qun [1]Hu 机构地区：[1]Department of Pediatrics,Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;[2]Department of Hematology/Oncology,Children’s Hospital of Fudan University,Shanghai 201100,China;[3]Department of Hematology/Oncology,Shanghai Children’s Medical Center,School of Medicine,Shanghai Jiao Tong University,Key Laboratory of Pediatric Hematology&Oncology of China Ministry of Health,Shanghai 200120,China;[4]Department of Hematology/Oncology,Chongqing Medical University Affiliated Children’s Hospital,Chongqing 400015,China;[5]Department of Pediatrics,Key Laboratory of Birth Defects and Related Disease of Women and Children,Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,China;[6]Department of Pediatrics,Xiangya Hospital Central South University,Changsha 410008,China;[7]Department of Pediatrics,Anhui Medical University Second Affiliated Hospital,Hefei 230601,China;[8]State Key Laboratory of Experimental Hematology and Division of Pediatric Blood Diseases Center,Institute of Hematology and Blood Diseases Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Tianjin 300020,China;[9]Department of Pediatrics,Hong Kong Children’s Hospital,The Chinese University of Hong Kong,Hong Kong SAR 999077,China;[10]Department of Pediatrics,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;[11]Department of Pediatrics,Nanfang Hospital,Southern Medical University,Guangzhou 516006,China;[12]Department of Hematology/Oncology,Children’s Hospital of Nanjing Medical University,Nanjing 210008,China;[13]Department of Hematology/Oncology,Shanghai Children’s Hospital,Shanghai Jiao Tong University,Shanghai 200062,China;[14]Department of Hematology/Oncology,Children’s Hospital of Soochow University,Suzhou 215002,China;[15]Department of Hematology/Oncology,Kunming Children’s Hospital,Kunming 650103,China;[16]Department of Hematology/Oncology,Guangzhou Women and Children’s Medical Center,Guangzhou 510620,China 出　　处：《Frontiers of Medicine》索引2023年第17卷第3期,共9页 基　　金：VIVA-China Children's Cancer Foundation and Prof.Pui team. 摘　　要：Venous thromboembolism(VTE)is a complication in children with acute lymphoblastic leukemia(ALL).The Chinese Children’s Cancer Group-ALL-2015 protocol was carried out in China,and epidemiology,clinical characteristics,and risk factors associated with VTE were analyzed.We collected data on VTE in a multiinstitutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December 2019.First,VTE occurred in 159(2.08%)patients,including 90(56.6%)during induction therapy and 108(67.92%)in the upper extremities.T-ALL had a 1.74-fold increased risk of VTE(95%CI 1.08–2.8,P=0.022).Septicemia,as an adverse event of ALL treatment,can significantly promote the occurrence of VTE(P<0.001).Catheter-related thrombosis(CRT)accounted for 75.47%(n=120);and,symptomatic VTE,58.49%(n=93),which was more common in patients aged 12–18 years(P=0.023),non-CRT patients(P<0.001),or patients with cerebral thrombosis(P<0.001).Of the patients with VTE treated with anticoagulation therapy(n=147),4.08%(n=6)had bleeding.The VTE recurrence rate was 5.03%(n=8).Patients with VTE treated by non-ultrasoundguided venous cannulation(P=0.02),with residual thrombus(P=0.006),or with short anticoagulation period(P=0.026)had high recurrence rates.Thus,preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence. 关 键 词：acute lymphoblastic leukemia CHILD venous thromboembolism EPIDEMIOLOGY clinical characteristic risk factor