Clinical presentation and therapeutic management of venous thrombosis in young children: a retrospective analysis.

Chan, Anthony; Lensing, Anthonie W A; Kubitza, Dagmar; Brown, Grahaem; Elorza, Dolores; Ybarra, Marta; Halton, Jacqueline; Grunt, Sebastian; Kenet, Gili; Bonnet, Damien; Santamaria, Amparo; Saracco, Paola; Biss, Tina; Climent, Francesco; Connor, Philip; Palumbo, Joseph; Thelen, Kirstin; Smith, William T; Mason, Amy; Adalbo, Ivet; ... (2018). Clinical presentation and therapeutic management of venous thrombosis in young children: a retrospective analysis. Thrombosis journal, 16(29), p. 29. BioMed Central 10.1186/s12959-018-0182-4

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Background Venous thromboembolism (VTE) in young children is not well documented. Methods Clinicians from 12 institutions retrospectively evaluated the presentation, therapeutic management, and outcome of VTE in children younger than 2 years seen in 2011-2016. Feasibility of recruiting these children in EINSTEIN-Jr. phase III, a randomized trial evaluating rivaroxaban versus standard anticoagulation for VTE, was assessed. Results We identified 346 children with VTE, of whom 227 (65.6%) had central venous catheter-related thrombosis (CVC-VTE), 119 (34.4%) had non-CVC-VTE, and 156 (45.1%) were younger than 1 month. Of the 309 children who received anticoagulant therapy, 86 (27.8%) had a short duration of therapy (i.e. < 6 weeks for CVC-VTE and < 3 months for non-CVC-VTE) and 17 (5.5%) had recurrent VTE during anticoagulation ( = 8, 2.6%) or shortly after its discontinuation ( = 9, 2.9%). A total of 37 (10.7%) children did not receive anticoagulant therapy and 4 (10.5%) had recurrent VTE.The average number of children aged < 0.5 years and 0.5-2 years who would have been considered for enrolment in EINSTEIN-Jr is approximately 1.0 and 0.9 per year per site, respectively. Conclusions Young children with VTE most commonly have CVC-VTE and approximately one-tenth and one-fourth received no or only short durations of anticoagulant therapy, respectively. Recurrent VTE rates without anticoagulation, during anticoagulation or shortly after its discontinuation seem comparable to those observed in adults. Short and flexible treatment durations could potentially increase recruitment in EINSTEIN-Jr. phase III.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Grunt, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1477-9560

Publisher:

BioMed Central

Language:

English

Submitter:

Karen Lidzba

Date Deposited:

21 Feb 2019 10:35

Last Modified:

26 Oct 2019 23:37

Publisher DOI:

10.1186/s12959-018-0182-4

PubMed ID:

30410424

Uncontrolled Keywords:

Anticoagulation Direct oral anticoagulant (DOAC/NOAC) Pediatric trial Registry Rivaroxaban Venous thromboembolism (VTE)

BORIS DOI:

10.7892/boris.123921

URI:

https://boris.unibe.ch/id/eprint/123921

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