PB0273 - Dealing with pediatric cancer associated thrombosis: a monocentric retrospective cohort study

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

EC

Elena Campello

Assistant Professor
Department of Medicine, University of Padova, Italy
Padova, Veneto, Italy

Co-Author(s)

AF

Andrea Francavilla

Postdoc
University of Padova
Padova, Veneto, Italy
SS

Stefano Sartori

Associate Professor
University of Padova
Padova, Veneto, Italy
CF

Chiara Forestan

doctor
Padova University Hospital
Padova, Veneto, Italy
SS

Sofia Sebellin

MD
University of Padova
Padova, Veneto, Italy
mP

maria Federica Pelizza

MD
University of Padova
Italy, Veneto, Italy
MN

Margherita Nosadini

MD
University of Padova
Padova, Veneto, Italy
JP

Jacopo Norberto Pin

MD
University of Padova
Padova, Veneto, Italy
AB

Alessandra Biffi

Full Professor
University of Padova
Padova, Veneto, Italy
DG

Dario Gregori

Full Professor
University of Padova
Padova, Veneto, Italy
GL

Giulia Lorenzoni

Associate Professor
University of Padova
Padova, Veneto, Italy
MM

Matteo Martinato

PhD
University of Padova
Padova, Veneto, Italy
Paolo Simioni, MD, PhD

Full Professor
Department of Medicine, Thrombotic and Haemorrhagic Diseases Unit, University of Padua Medical School, Padua (Italy)
Padua, Veneto, Italy

Background: Little is known about cancer-associated thrombosis (CAT) in children.

Aims: In this retrospective cohort study we aim to describe clinical presentation, management and outcomes of pediatric CAT.

Methods: All consecutive patients admitted at the Pediatric Department of the Padova University Hospital between January 2007 and December 2021 with a thrombotic event were retrospectively enrolled. Inclusion criteria were age >28 days, acute venous or arterial thrombosis confirmed by objective tests (ultrasound, magnetic resonance imaging, magnetic resonance angiography, computed tomography, computed tomography angiography, angiography, ventilation-perfusion scan), cancer among risk factors. Clinical outcomes including thrombosis-related death, recurrence and bleeding complications were recorded.

Results: During the study period, 59 pediatric patients with CAT were considered (Table 1). The most involved neoplasms were hematological malignancies. 24 events (40.6%) were cerebral arterial thrombosis; 35 (59%) were venous thrombosis (VTE, 8 cerebral vein, 25 systemic vein thrombosis and 2 pulmonary embolism). Of 27 VTE, 15 (55%) were CVC-related, 19 (70%) were symptomatic. Main signs/symptoms were 4 catheter malfunction, 2 dyspnea and 13 limb edema and pain. Antithrombotic therapy was administered in 51/59 (86%) of patients, mainly heparin (98%) (low molecular weight heparin [mean dosage 162.25 U/kg/die] or unfractionated heparin [mean dosage 19.7 U/kg/h]). One patient was treated with warfarin (2%). As for the outcomes, 2 patients died of CAT-related death (3.4%), 6 patients (10.1%) underwent CAT recurrence after a mean period of 540 weeks [IQR 428-652]. Recurrence events were 3 cerebral vein and 3 systemic vein thrombosis. As for bleeding complications only 3 minor events were reported (5%).

Conclusion(s): Pediatric CAT characteristics and outcome resemble those of adult CAT. Particularly, a high incidence of both arterial and venous events was reported; hematological neoplasms and CVC are the major risk factors; heparin the only used therapeutic option; a high incidence rate of recurrence was detected.