PB0270 - Rivaroxaban for the treatment of thrombosis in pediatric patients with leukemia. Results of a pilot study

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Samantha Carolina Rodriguez Miranda, MD

Pediatric Hematology Fellow
Universidad Autonoma de Nuevo Leon
San Nicolas De los Garza, Nuevo Leon, Mexico

Co-Author(s)

JC

Julia Esther Colunga Pedraza

Professor
Universidad Autonoma de Nuevo Leon
Monterrey, Nuevo Leon, Mexico
LV

Laura Villarreal Martinez

Professor
Hospital Universitario Dr. José Eleuterio González
Monterrey, Nuevo Leon, Mexico
MZ

Maria Sthefany Zazueta Martinez

Pediatric hematology Fellow
UANL
Monterrey, Nuevo Leon, Mexico
SR

Sergio Antonio Ramirez Cortinas

Pediatric Hematology Fellow
UANL
Monterrey, Nuevo Leon, Mexico
LH

Lucia Elizabeth Hernandez Torres

Pediatric hematology Fellow
UANL
Monterrey, Nuevo Leon, Mexico
SF

Samantha Fierro Saenz

Pediatric hematology Fellow
UANL
Monterrey, Nuevo Leon, Mexico
HR

Hernan Ramirez Duran

Pediatric hematology Fellow
UANL
Monterrey, Nuevo Leon, Mexico
GA

Galia Alison Aliaga Orellana

Pediatric hematology Fellow
UANL
Monterrey, Nuevo Leon, Mexico

Background: Venous thromboembolism (VTE) in children with acute lymphoblastic leukemia (ALL) is a multifactorial entity whose timely diagnosis and treatment are vital to avoid sequelae. Factors associated with the presence of a prothrombotic state include the underlying disease, catheter placement, immobilization, obesity, and drugs such as steroids and L-asparaginase. In children thrombosis treatment with rivaroxaban resulted in a similarly low recurrence risk without increased bleeding, as compared with standard anticoagulants. It is also an affordable therapy and easier to use.

Aims: To describe the results of the treatment regimen with enoxaparin for 7 days and then rivaroxaban for a minimum of 3 months in pediatric patients with ALL whom development of VTE.

Methods: Pediatric patients with ALL who developed VTE from 2020 to 2021 were included. Patients received treatment with enoxaparin for 7 days and then received a bodyweight-adjusted 20 mg equivalent dose of rivaroxaban, given once-daily (≥30 kg) or twice-daily (12–30 Kg) for a minimum of 3 months. Weekly clinical follow-up was performed, bleeding events were recorded.

Results: Symptomatic thrombotic events were documented in 6 of 77 included patients diagnosed with ALL (7.8%). The mean age of the patients who presented thrombosis was 9.6 years (1-16). One patient was obese (16%). Three patients (50%) were receiving L-asparaginase and steroids and 2 (33%) had central venous access.
After 90 days no child present symptomatic recurrent VTE or bleeding events. Complete clinical resolution occurred in 66%. Adverse events were not reported.

Conclusion(s): We found a frequency of thrombosis of 7.8% in our population; the VTE treatment regimen with rivaroxaban was effective with no significant toxicities. Although it is a very small group, we found it as an attractive therapeutic option.