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Thromboembolism in ...
Thromboembolism in acute lymphoblastic leukemia : results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
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- Rank, Cecilie Utke (author)
- Univ Copenhagen, Rigshosp, Pediat Oncol Res Lab, Copenhagen, Denmark;Univ Copenhagen, Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Toft, Nina (author)
- Univ Copenhagen, Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Tuckuviene, Ruta (author)
- Aalborg Univ Hosp, Dept Pediat, Aalborg, Denmark
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- Grell, Kathrine (author)
- Univ Copenhagen, Fac Hlth & Med Sci, Dept Publ Hlth, Sect Biostat, Copenhagen, Denmark
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- Nielsen, Ove Juul (author)
- Univ Copenhagen, Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Frandsen, Thomas Leth (author)
- Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
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- Marquart, Hanne Vibeke Hansen (author)
- Univ Copenhagen, Rigshosp, Dept Clin Immunol, Copenhagen, Denmark
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- Albertsen, Birgitte Klug (author)
- Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark
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- Tedgard, Ulf (author)
- Lund Univ Hosp, Dept Pediat & Coagulat Disorders, Malmo, Sweden
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- Hallböök, Helene (author)
- Uppsala universitet,Hematologi
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- Ruud, Ellen (author)
- Oslo Univ Hosp, Rikshosp, Dept Paediat Med, Oslo, Norway
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- Jarvis, Kirsten Brunsvig (author)
- Oslo Univ Hosp, Rikshosp, Dept Paediat Med, Oslo, Norway
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- Quist-Paulsen, Petter (author)
- Trondheim Reg & Univ Hosp, St Olavs Hosp, Dept Hematol, Trondheim, Norway
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- Huttunen, Pasi (author)
- Helsinki Univ Hosp, Childrens Hosp, Dept Pediat Hematol Oncol & Stem Cell Transplanta, Helsinki, Finland
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- Wartiovaara-Kautto, Ulla (author)
- Helsinki Univ Hosp, Ctr Comprehens Canc, Dept Hematol, Helsinki, Finland;Univ Helsinki, Helsinki, Finland
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- Jonsson, Olafur Gisli (author)
- Univ Hosp, Landspitali, Childrens Hosp, Reykjavik, Iceland
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- Trakymiene, Sonata Saulyte (author)
- Vilnius Univ Hosp Santaros Klin, Childrens Hosp, Ctr Pediat Oncol & Hematol, Vilnius, Lithuania
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- Griskevicius, Laimonas (author)
- Vilnius Univ Hosp Santaros Klin, Dept Hematol Oncol & Transfus Med Ctr, Vilnius, Lithuania;Vilnius Univ, Vilnius, Lithuania
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- Saks, Kadri (author)
- Tallinn Childrens Hosp, Dept Oncohematol, Tallinn, Estonia
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- Punab, Mari (author)
- Tartu Univ Hosp, Dept Hematol & Oncol, Tartu, Estonia
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- Schmiegelow, Kjeld (author)
- Univ Copenhagen, Rigshosp, Pediat Oncol Res Lab, Copenhagen, Denmark;Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark;Univ Copenhagen, Fac Med, Inst Clin Med, Copenhagen, Denmark
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(creator_code:org_t)
- AMER SOC HEMATOLOGY, 2018
- 2018
- English.
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In: Blood. - : AMER SOC HEMATOLOGY. - 0006-4971 .- 1528-0020. ; 131:22, s. 2475-2484
- Related links:
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https://ashpublicati...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during the treatment of 1772 consecutive Nordic/Baltic patients with ALL aged 1 to 45 years who were treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol (July 2008-April 2017). The 2.5-year cumulative incidence of thromboembolism (N = 137) was 7.9% (95% confidence interval [CI], 6.6-9.1); it was higher in patients aged at least 10 years (P < .0001). Adjusted hazard ratios (HRas) were associated with greater age (range, 10.0-17.9 years: HRa, 4.9 [95% CI, 3.1-7.8; P < .0001]; 18.0-45.9 years: HRa, 6.06 [95% CI, 3.65-10.1; P < .0001]) and mediastinal mass at ALL diagnosis (HRa, 2.1; 95% CI, 1.0-4.3; P = .04). In a multiple absolute risk regression model addressing 3 thromboembolism risk factors, age at least 10 years had the largest absolute risk ratio (RRage, 4.7 [95% CI, 3.1-7.1]; RRenlarged (lymph nodes), 2.0 [95% CI, 1.2-3.1]; RRmediastinal mass, 1.6 [95% CI, 1.0-2.6]). Patients aged 18.0 to 45.9 years had an increased hazard of pulmonary embolism (HRa, 11.6; 95% CI, 4.02-33.7; P < .0001), and patients aged 10.0 to 17.9 years had an increased hazard of cerebral sinus venous thrombosis (HRa, 3.3; 95% CI, 1.5-7.3; P = .003) compared with children younger than 10.0 years. Asparaginase was truncated in 38/128 patients with thromboembolism, whereas thromboembolism diagnosis was unassociated with increased hazard of relapse (P = .6). Five deaths were attributable to thromboembolism, and patients younger than 18.0 years with thromboembolism had increased hazard of dying compared with same-aged patients without thromboembolism (both P <= .01). In conclusion, patients aged at least 10 years could be candidates for preemptive antithrombotic prophylaxis. However, the predictive value of age 10 years or older, enlarged lymph nodes, and mediastinal mass remain to be validated in another cohort.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
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Rank, Cecilie Ut ...
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Toft, Nina
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Tuckuviene, Ruta
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Grell, Kathrine
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Nielsen, Ove Juu ...
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Frandsen, Thomas ...
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Marquart, Hanne ...
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Albertsen, Birgi ...
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Tedgard, Ulf
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Hallböök, Helene
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Ruud, Ellen
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Jarvis, Kirsten ...
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Quist-Paulsen, P ...
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Huttunen, Pasi
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Wartiovaara-Kaut ...
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Jonsson, Olafur ...
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Trakymiene, Sona ...
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Griskevicius, La ...
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Saks, Kadri
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Punab, Mari
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Schmiegelow, Kje ...
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Blood
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Uppsala University