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Predictors of thrombosis in children receiving therapy for acute lymphoblastic leukemia: Results from Dana-Farber Cancer Institute ALL Consortium trial 05-001.

التفاصيل البيبلوغرافية
العنوان: Predictors of thrombosis in children receiving therapy for acute lymphoblastic leukemia: Results from Dana-Farber Cancer Institute ALL Consortium trial 05-001.
المؤلفون: Athale UH; Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada., Flamand Y; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts., Blonquist T; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts., Stevenson KE; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts., Spira M; Department of Pediatrics, New York-Presbyterian Hospital, New York, New York., Asselin BL; Department of Pediatrics, University of Rochester Medical Center and School of Medicine, Rochester, New York., Clavell LA; San Jorge Children's Hospital, San Juan, Puerto Rico., Cole PD; Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey., Kelly KM; Roswell Park Comprehensive Cancer Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York., Laverdiere C; Hematology-Oncology Division, Charles Bruneau Cancer Center, Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada., Leclerc JM; Hematology-Oncology Division, Charles Bruneau Cancer Center, Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada., Michon B; Centre Hospitalier Universitaire de Quebec, Sainte-Foy, Quebec, Canada., Schorin MA; Inova L. J. Murphy Children's Hospital, Falls Church, Virginia., Welch JJG; Pediatric Hematology Oncology, Hasbro Children's Hospital/Brown University, Providence, Rhode Island., Harris MH; Department of Pathology, Boston Children's Hospital, Boston, Massachusetts., Neuberg DS; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts., Sallan SE; Department of Pediatric Oncology, Dana-Farber Cancer Institute and Division of Pediatric Hematology-Oncology, Boston Children's Hospital, Boston, Massachusetts., Silverman LB; Department of Pediatric Oncology, Dana-Farber Cancer Institute and Division of Pediatric Hematology-Oncology, Boston Children's Hospital, Boston, Massachusetts.
المصدر: Pediatric blood & cancer [Pediatr Blood Cancer] 2022 Aug; Vol. 69 (8), pp. e29581. Date of Electronic Publication: 2022 Mar 22.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: John Wiley Country of Publication: United States NLM ID: 101186624 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-5017 (Electronic) Linking ISSN: 15455009 NLM ISO Abbreviation: Pediatr Blood Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hoboken, N.J. : John Wiley, c 2004-
مواضيع طبية MeSH: Blood Group Antigens*/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma*/complications , Thrombosis*/chemically induced , Thrombosis*/epidemiology , Venous Thromboembolism*, Anticoagulants/adverse effects ; Child ; Child, Preschool ; Humans ; Male ; Risk Factors
مستخلص: Background/objectives: Although thromboembolism (TE) is a serious complication in patients with acute lymphoblastic leukemia (ALL), thromboprophylaxis is not commonly used due to the inherent bleeding risk in this population. Identifying prothrombotic risk factors will help target thromboprophylaxis to those at highest thrombotic risk. We aimed to define predictors and the impact of TE on ALL outcome in children (1-18 years) treated on the Dana-Farber Cancer Institute ALL 05-001 trial.
Methods: Clinical and laboratory data including TE events were prospectively collected. PCR-based allelic discrimination assay identified single-nucleotide polymorphisms (SNP) for prothrombin G20210A (rs1799963) and Factor V G1691A (rs6025). Univariate and multivariable competing risk regression models evaluated the effect of diagnostic clinical (age, sex, body mass index, ALL-immunophenotype, risk group) and laboratory variables (presenting leukocyte count, blood group, SNPs) on the cumulative incidence of TE. Cox regression modeling explored the impact of TE on survival.
Results: Of 794 patients [median age 4.97 (range, 1.04-17.96) years; males 441], 100 developed TE; 25-month cumulative incidence 13.0% (95% CI, 10.7%-15.5%). Univariate analyses identified older age (≥10 years), presenting leucocyte count, T-ALL, high-risk ALL, and non-O blood group as risk factors. Age and non-O blood group were independent predictors of TE on multivariable regression; the blood group impact being most evident in patients 1-5 years of age (P = 0.011). TE did not impact survival. Induction TE was independently associated with induction failure (OR 6.45; 95% CI, 1.64-25.47; P = 0.008).
Conclusion: We recommend further evaluation of these risk factors and consideration of thromboprophylaxis for patients ≥10 years (especially those ≥15 years) when receiving asparaginase.
(© 2022 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: ABO blood group; acute lymphoblastic leukemia; adolescents and young adults; children; predictors; thromboembolism
المشرفين على المادة: 0 (Anticoagulants)
0 (Blood Group Antigens)
تواريخ الأحداث: Date Created: 20220322 Date Completed: 20220627 Latest Revision: 20220714
رمز التحديث: 20240628
DOI: 10.1002/pbc.29581
PMID: 35316569
قاعدة البيانات: MEDLINE
الوصف
تدمد:1545-5017
DOI:10.1002/pbc.29581