OC 06.5 - Recurrent thrombosis in children: A ten-year registry from a single tertiary center in Argentina

Saturday, June 22, 2024

14:00 – 14:15 ICT

Room: 111 A-C

Presenting Author(s)

Carolina Cervio

Pediatric hematologist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina

Co-Author(s)

MB

María Belén Bianco

Pediatric hematologist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina
SA

S. Eliana Annetta

Biochemist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina
Juan Pablo Frontroth, Biochemist

Biochemist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina
CP

Carolina M Pepe

Biochemist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina
RS

R. Emanuel Sueldo

Biochemist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina
MH

Mirta Hepner

Biochemist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina
GS

Gabriela Sciuccati

Pediatric hematologist staff
Hospital de Pediatría Prof. Dr. J.P. Garrahan
CABA, Ciudad Autonoma de Buenos Aires, Argentina

Background: Venous thromboembolism (VTE) recurrence may cause morbidity and mortality.There is limited information regarding VTE recurrence`s characteristics in children.

Aims: To describe a cohort of children with recurrent thrombosis(RT). To compare clinical characteristics of patients with and without RT.

Methods: Single-center observational study, Jan/13-June/23.Consecutive patients(pts) >1 month and < 18 years of age with a first objectively confirmed VTE were prospectively registered. Recurrence and progression were defined according to the 2011 and 2023 ISTH guidances. Thrombophilia testing(TT) was performed according to the judgment of the treating team. Anticoagulant treatment at the moment of RT was classified as: full-dose, shortly interrupted and no anticoagulation. Results are expressed as median, range. Significance-level of p< 0.05 was used. Stata 15.0 was employed for statistical analysis.

Results: A total of 165 events of RT were detected in 129/647pts with VTE (19.9%). Recurrence: 92pts, progression: 21pts, both:16pts. Median follow-up: 2.2 years (0.5-10.8). Clinical and recurrence characteristics are depicted in Tables 1 and 2. RT events under full-dose anticoagulation, 22(13.3%) and during short interruption of anticoagulation, 36(21,8%). TT was performed in 32 patients, in 15 of them a prothrombotic disorder was detected. Among the 5 patients with unprovoked VTE with RT, TT showed: persistent antiphospholipid antibodies, 2pts; protein S deficiency, 1pt; heterozygous factor V Leiden with increased FVIII level, 1pt.

Conclusion(s): In this large pediatric cohort, a high thrombotic recurrence prevalence was observed. Significant higher frequency of recurrent thrombosis was found in short bowel syndrome`s patients. Prothrombotic disorders were detected in the majority of unprovoked VTE patients. Recurrent thrombosis occurred early during follow-up and was infrequent under full-dose anticoagulation. Timely anticoagulant therapy avoiding interruptions may prevent recurrent events.