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Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options
Venous thromboembolism (VTE) occurs in 2.1 to up to 50% of children with cancer and contributes to long term morbidity as well as early mortality in this population. Pediatric patients with malignancy are predisposed to VTE due to the prothrombotic nature of cancer and its associated coagulopathies...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021605/ https://www.ncbi.nlm.nih.gov/pubmed/35463883 http://dx.doi.org/10.3389/fped.2022.855162 |
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author | Samji, Nasrin Bhatt, Mihir D. Kulkarni, Ketan |
author_facet | Samji, Nasrin Bhatt, Mihir D. Kulkarni, Ketan |
author_sort | Samji, Nasrin |
collection | PubMed |
description | Venous thromboembolism (VTE) occurs in 2.1 to up to 50% of children with cancer and contributes to long term morbidity as well as early mortality in this population. Pediatric patients with malignancy are predisposed to VTE due to the prothrombotic nature of cancer and its associated coagulopathies as well as chemotherapeutic agents, use of central venous catheters, surgery, radiotherapy, and concomitant thrombophilia. Management of thrombosis in this population is challenging due to concomitant thrombocytopenia, associated bleeding risks, concurrent co-morbidities, and toxicities of therapy. The aim of this paper is to highlight clinically relevant issues and management dilemmas using clinical vignettes. We review the clinical significance of asymptomatic and symptomatic thrombosis, examine the various options for asparaginase-associated thrombosis, address the role and controversies of direct oral anticoagulants, and describe our approach to managing anticoagulation therapy in the context of chemotherapy-induced thrombocytopenia. |
format | Online Article Text |
id | pubmed-9021605 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90216052022-04-22 Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options Samji, Nasrin Bhatt, Mihir D. Kulkarni, Ketan Front Pediatr Pediatrics Venous thromboembolism (VTE) occurs in 2.1 to up to 50% of children with cancer and contributes to long term morbidity as well as early mortality in this population. Pediatric patients with malignancy are predisposed to VTE due to the prothrombotic nature of cancer and its associated coagulopathies as well as chemotherapeutic agents, use of central venous catheters, surgery, radiotherapy, and concomitant thrombophilia. Management of thrombosis in this population is challenging due to concomitant thrombocytopenia, associated bleeding risks, concurrent co-morbidities, and toxicities of therapy. The aim of this paper is to highlight clinically relevant issues and management dilemmas using clinical vignettes. We review the clinical significance of asymptomatic and symptomatic thrombosis, examine the various options for asparaginase-associated thrombosis, address the role and controversies of direct oral anticoagulants, and describe our approach to managing anticoagulation therapy in the context of chemotherapy-induced thrombocytopenia. Frontiers Media S.A. 2022-04-07 /pmc/articles/PMC9021605/ /pubmed/35463883 http://dx.doi.org/10.3389/fped.2022.855162 Text en Copyright © 2022 Samji, Bhatt and Kulkarni. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Samji, Nasrin Bhatt, Mihir D. Kulkarni, Ketan Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options |
title | Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options |
title_full | Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options |
title_fullStr | Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options |
title_full_unstemmed | Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options |
title_short | Challenges in Management of VTE in Children With Cancer: Risk Factors and Treatment Options |
title_sort | challenges in management of vte in children with cancer: risk factors and treatment options |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021605/ https://www.ncbi.nlm.nih.gov/pubmed/35463883 http://dx.doi.org/10.3389/fped.2022.855162 |
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