%A Mengmeng Yin, Hongsheng Wang, Xianmin Guan, Ju Gao, Minghua Yang, Ningling Wang, Tianfeng Liu, Jingyan Tang, Alex WK Leung, Fen Zhou, Xuedong Wu, Jie Huang, Hong Li, Shaoyan Hu, Xin Tian, Hua Jiang, Jiaoyang Cai, Xiaowen Zhai, Shuhong Shen, Qun Hu %T Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese Children’s Cancer Group-ALL-2015 %0 Journal Article %D 2023 %J Front. Med. %J Frontiers of Medicine %@ 2095-0217 %R 10.1007/s11684-022-0958-6 %P 518-526 %V 17 %N 3 %U {https://journal.hep.com.cn/fmd/EN/10.1007/s11684-022-0958-6 %8 2023-06-15 %X

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 multi-institutional 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-ultrasound-guided 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.