scholarly journals Deep veins thrombosis in children with blood diseases

2019 ◽  
Vol 14 (1) ◽  
pp. 20-30 ◽  
Author(s):  
P. A. Zharkov ◽  
D. S. Morozova ◽  
D. A. Gobadze ◽  
D. A. Evstratov ◽  
D. V. Fedorova ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Lymphoblastic Leukemia ◽  
Clinical Signs ◽  
Blood Disorders ◽  
Blood Diseases ◽  
Vein Thrombosis ◽  
Gender And Age ◽  
Thrombotic Complications ◽  
Hodgkin's Lymphomas ◽  
Deep Vein

Background.Children and adolescents undergoing treatment in the hospital for blood diseases are at risk of thrombotic complications. However, to date no major studies of the prevalence of thrombosis in this category of patients have been conducted in Russia.The objective:to determine the incidence of symptomatic and asymptomatic deep vein thrombosis (DVT), as well as their distribution by gender and age in children with various blood disorders.Materials and methods.Medical records of 1962 patients, aged from 0 to 17 years, were retrospectively analyzed. All DVT cases were confirmed by visualization methods. The presence of thrombosis clinical signs detected during physical examination, allowed identifying symptomatic DVT.Results.DVT was diagnosed in 429 patients; the symptomatic (n = 110) and asymptomatic (n = 337) DVT were considered as two independent groups with cases of thrombosis. The highest incidence of thrombotic complications was found in children with acute lymphoblastic leukemia (ALL) – 30.77 %, non-Hodgkin’s lymphomas – 22.58 %, other malignant blood disorders – 18.75 %, myeloid leukemia – 15.63 %, Hodgkin’s lymphoma – 16.50 %, histiocytosis – 12.5 %, aplastic anemia – 7.94 %, other leukemia – 7.14 %. Symptomatic episodes were more common in patients with lymphomas, especially non-Hodgkin’s, and ALL, while asymptomatic DVT were more common among children with ALL.Conclusion.The DVT prevalence in children with blood disorders exceeds 20 %, most of them are asymptomatic thrombosis, while symptomatic DVT are much less common. Patients receiving treatment for lymphomas and ALL have the highest number of venous thrombotic complications. Further research is needed to address the need for primary thrombotic prophylaxis in children with blood disorders.

Recurrent deep vein thromboses in children with blood diseases. The results of a single center trial

2019 ◽  
Author(s):  
П.А. Жарков ◽  
Д.С. Морозова ◽  
Д.А. Евстратов ◽  
Д.В. Федорова ◽  
Ю.А. Шифрин ◽  
...  
Keyword(s):  
Lymphoblastic Leukemia ◽  
Secondary Prophylaxis ◽  
Future Research ◽  
Hospitalized Children ◽  
Recurrent Thrombosis ◽  
Bone Marrow Aplasia ◽  
Single Episode ◽  
Blood Diseases ◽  
Vein Thrombosis ◽  
Deep Vein

Введение. Тромбозы глубоких вен (ТГВ) являются нередким осложнением течения и лечения у детей с заболеваниями крови и требуют проведения антитромботической терапии и профилактики для снижения количества повторных тромботических эпизодов. Цель исследования: анализ частоты и определение факторов риска повторных ТГВ у детей, госпитализированных для лечения заболеваний крови. Материалы и методы. Проведен ретроспективный анализ электронной базы данных пациентов в возрасте от 0 до 17 лет включительно, которым проводили стационарное лечение гемобластозов и синдромов костномозговой недостаточности в период 01.0.2012 по 31.12.2017. В анализ вошли только те пациенты, у которых было зарегистрировано более 1 случая тромбоза. Результаты. Рецидивы тромбозов наблюдали у 13,3 детей с асимптоматическими (аТГВ) и у 5,4 с симптоматическими (сТГВ) ТГВ. Рецидивы аТГВ при остром лимфобластном лейкозе (ОЛЛ) выявлены у 14,5, при остром миелобластном лейкозе (ОМЛ) у 8,9, при лимфоме у 11,9. У детей с сТГВ рецидивы тромбоза выявлены при ОЛЛ у 8,2, при ОМЛ у 8,3, при лимфоме у 2,8 пациентов. Медиана возраста пациентов с единственным эпизодом сТГВ составила 10 лет, с рецидивом сТГВ 9 лет, при аТГВ 7 лет для пациентов с единственным эпизодом и 6 лет с рецидивом аТГВ. Некорректно проведенная терапия была зарегистрирована у 50 детей. Заключение. Рецидивирующее течение тромбоза у детей, госпитализированных для лечения заболеваний крови, уста новлено у 5,4 детей с сТГВ и у 13,3 детей с аТГВ, причем 1/3 часть сТГВ является потенциально жизнеугрожающей. Полученные данные подчеркивают необходимость проведения вторичной антитромботической профилактики у детей с ТГВ и ставят вопрос о необходимости и целесообразности проведения таковой у пациентов с аТГВ. Introduction. Deep vein thrombosis (DVT) remains a common complication of hematological diseases in children and requires antithrombotic therapy and prophylaxis of recurrent thrombotic events. Aim: to determine incidence and risk factors of recurrent DVT for hospitalized children with blood diseases. Materials and methods. Medical records of patients hospitalized with oncohematological diseases and bone marrow aplasia, aged from 0 to 17 years, were analyzed retrospectively. Only patients with more than one DVT were taken into this analysis. Results. Recurrent DVT was diagnosed in 13.27 children with asymptomatic DVT (aDVT) and in 5.41 with symptomatic DVT (sDVT). Recurrent DVT was found in 14.49 children with acute lymphoblastic leukemia (ALL), in 8.89 with acute myeloblastic leukaemia (AML), in 11.86 with lymphomas. Incidence of recurrent thrombosis in children with sDVT was 8.16 for ALL, 8.33 for AML, 2.78 for lymphomas. Age analysis of patients with the single episode and recurrent thrombosis showed that age median with single sDVT was 10 years, recurrent DVT 9 years, in case of single asymptomatic or incidental (aDVT) episode 7 years, recurrent DVT 6 years. Incorrect therapy was registered for 50 of children with recurrent sDVT. Conclusion. Recurrent DVT in hospitalized children with blood diseases occurred in 5.41 children with sDVT and in children 13.33 with aDVT 1/3 episodes of sDVT was lifethreatening. In conclusion, secondary prophylaxis is needed for children with DVT and future research should be done for prophylaxis in those with aDVT.

Intensive Initial Oral Anticoagulation and Shorter Heparin Treatment in Deep Vein Thrombosis

1984 ◽  
Vol 52 (03) ◽  
pp. 276-280 ◽  
Author(s):  
Sam Schulman ◽  
Dieter Lockner ◽  
Kurt Bergström ◽  
Margareta Blombäck
Keyword(s):  
Deep Vein Thrombosis ◽  
Oral Anticoagulation ◽  
Dose Group ◽  
Low Dose ◽  
Clinical Signs ◽  
Coagulation Factor ◽  
High Dose ◽  
Vein Thrombosis ◽  
Heparin Treatment ◽  
Deep Vein

SummaryIn order to investigate whether a more intensive initial oral anticoagulation still would be safe and effective, we performed a prospective randomized study in patients with deep vein thrombosis. They received either the conventional regimen of oral anticoagulation (“low-dose”) and heparin or a more intense oral anticoagulation (“high-dose”) with a shorter period of heparin treatment.In the first part of the study 129 patients were randomized. The “low-dose” group reached a stable therapeutic prothrombin complex (PT)-level after 4.3 and the “high-dose” group after 3.3 days. Heparin was discontinued after 6.0 and 5.0 days respectively. There was no difference in significant hemorrhage between the groups, and no clinical signs of progression of the thrombosis.In the second part of the study another 40 patients were randomized, followed with coagulation factor II, VII, IX and X and with repeated venograms. A stable therapeutic PT-level was achieved after 4.4 (“low-dose”) and 3.7 (“high-dose”) days, and heparin was discontinued after 5.4 and 4.4 days respectively. There were no clinical hemorrhages, the activity of the coagulation factors had dropped to the same level in both groups at the time when heparin was discontinued and no thromboembolic complications occurred.Our oral anticoagulation regimen with heparin treatment for an average of 4.4-5 days seems safe and reduces in-patient costs.

scholarly journals Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound

2013 ◽  
Vol 12 (2) ◽  
pp. 118-122
Author(s):  
Liz Andrea Villela Baroncini ◽  
Graciliano Jose Franca ◽  
Aguinaldo de Oliveira ◽  
Enrique AntonioVidal ◽  
Carlos Eduardo Del Valle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Below The Knee ◽  
Clinical Conditions ◽  
Deep Vein

BACKGROUND: Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. OBJECTIVES: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. METHODS: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. RESULTS: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1.45-3.72; p<0.001), and PE (OR=2.62; 95%CI 1.29-5.32; p=0.008).Time since the onset of symptoms did not differ between the groups. CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT.

scholarly journals ACUTE MYELOID LEUKEMIA-M3V WITH DEEP VEIN THROMBOSIS, A RARE PRESENTATION

2014 ◽  
Vol 3 (2) ◽  
pp. 241-245
Author(s):  
Mani Mekhala P ◽  
Lavanya M ◽  
Aruna L ◽  
Shajia Rehman ◽  
Pooja Deshmukh
Keyword(s):  
Acute Myeloid Leukemia ◽  
Deep Vein Thrombosis ◽  
Myeloid Leukemia ◽  
Rare Presentation ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Acute Myeloid

scholarly journals Incidence of Upper Extremity Deep Vein Thrombosis in Acute Leukemia and Effect on Mortality

TH Open ◽  
2020 ◽  
Vol 04 (04) ◽  
pp. e309-e317
Author(s):  
Christina Poh ◽  
Ann Brunson ◽  
Theresa Keegan ◽  
Ted Wun ◽  
Anjlee Mahajan
Keyword(s):  
Deep Vein Thrombosis ◽  
Acute Leukemia ◽  
Upper Extremity ◽  
Lymphoblastic Leukemia ◽  
Cox Proportional Hazards ◽  
High Risk Population ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Deep Vein ◽  
The Impact

AbstractThe cumulative incidence, risk factors, rate of subsequent venous thromboembolism (VTE) and bleeding and impact on mortality of isolated upper extremity deep vein thrombosis (UE DVT) in acute leukemia are not well-described. The California Cancer Registry, used to identify treated patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) diagnosed between 2009 and 2014, was linked with the statewide hospitalization database to determine cumulative incidences of UE DVT and subsequent VTE and bleeding after UE DVT diagnosis. Cox proportional hazards regression models were used to assess the association of UE DVT on the risk of subsequent pulmonary embolism (PE) or lower extremity deep vein thrombosis (LE DVT) and subsequent bleeding, and the impact of UE DVT on mortality. There were 5,072 patients identified: 3,252 had AML and 1,820 had ALL. Three- and 12-month cumulative incidences of UE DVT were 4.8% (95% confidence interval [CI]: 4.1–5.6) and 6.6% (95% CI: 5.8–7.5) for AML and 4.1% (95% CI: 3.2–5.1) and 5.9% (95% CI: 4.9–7.1) for ALL, respectively. Twelve-month cumulative incidences of subsequent VTE after an incident UE DVT diagnosis were 5.3% for AML and 12.2% for ALL. Twelve-month cumulative incidences of subsequent bleeding after an incident UE DVT diagnosis were 15.4% for AML and 21.1% for ALL. UE DVT was associated with an increased risk of subsequent bleeding for both AML (hazard ratio [HR]: 2.07; 95% CI: 1.60–2.68) and ALL (HR: 1.62; 95% CI: 1.02–2.57) but was not an independent risk factor for subsequent PE or LE DVT for either leukemia subtype. Isolated incident UE DVT was associated with increased leukemia-specific mortality for AML (HR: 1.42; 95% CI: 1.16–1.73) and ALL (HR: 1.80; 95% CI: 1.31–2.47). UE DVT is a relatively common complication among patients with AML and ALL and has a significant impact on bleeding and mortality. Further research is needed to determine appropriate therapy for this high-risk population.

Chronic Venous Insufficiency of the Upper Limb Due to Outflow Obstruction of Venous Access

1988 ◽  
Vol 3 (4) ◽  
pp. 265-270
Author(s):  
A. Halevy ◽  
A. Zelikovski ◽  
D. Modai ◽  
Y. Swissgarten ◽  
R. Orda
Keyword(s):  
Upper Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Signs ◽  
Venous Access ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Short Period ◽  
Cubital Fossa ◽  
Deep Vein

Two patients with angio-access for haemodialysis in whom the main venous outflow tract was thrombosed, developed severe chronic venous insufficiency (CVI) of the upper limb after a short period; one case developing a stasis ulcer of the cubital fossa. The angio-accesses were still functioning when the diagnosis was made. Treatment by surgery resulted in a dramatic regression of clinical signs of chronic venous insufficiency. CVI of the upper limb has not previously been described. CVI is a frequent and known complication after deep vein thrombosis (DVT) of the lower limbs, but never appears after DVT of the upper limbs. We describe two cases of upper limb CVI which developed as a complication of angio-access for haemodialysis treatment, and their successful treatment by surgery.

CLINICAL SIGNS OF DEEP-VEIN THROMBOSIS

The Lancet ◽  
1972 ◽  
Vol 299 (7745) ◽  
pp. 321 ◽  
Author(s):  
I.J.T. Davies
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Signs ◽  
Vein Thrombosis ◽  
Deep Vein

The Natural History of Idiopathic Erythrocythosis: A Cohort Study of 74 Patients.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1506-1506
Author(s):  
Finazzi Guido ◽  
Ruggeri Marco ◽  
Marconi Monica ◽  
Rodeghiero Francesco ◽  
Barbui Tiziano
Keyword(s):  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Natural History ◽  
Thrombotic Event ◽  
Previous History ◽  
Full Blood Count ◽  
Vein Thrombosis ◽  
History Of ◽  
Thrombotic Complications ◽  
Deep Vein

Abstract Patients with absolute erythrocytosis not due to a detectable cause and not fulfilling the criteria for diagnosis of polycythemia vera (PV) are descriptively classified as Idiopathic Erythrocytosis (IE). Based on scanty and retrospective data, this disease is considered to be an heterogeneous entity, including “early” PV, unrecognized secondary erythrocytosis and other miscellaneous conditions. However, appropriate prospective studies to evaluate the natural history of patients with IE are not available. We report here the results of a cohort study of 74 patients with IE (66 males, 8 females, median age 56 years, range 14–82) followed in two Italian institutions. By definition, at baseline all IE patients had increased hematocrit (median 54%, range 48–68%) and increased red blood cell mass (> 25% above mean normal predicted value), but normal leukocyte (median values 8.1 x 109/L, range 2.3–12) and platelet counts (median values 197 x 109/L, range 117–467), as well as normal erythropoietin level, arterial O2 saturation, chest X ray and abdominal ultrasound scanning (i.e. no splenomegaly). Granulocyte PRV-1 expression was also normal in 29 patients (39%) analyzed. At diagnosis, 12 patients (16%) reported a previous history of major thrombosis (7 ischemic cardiopathies, 4 cerebral ischemic events and 1 deep vein thrombosis). All IE patients were treated with phlebotomy to maintain a target hematocrit <45% and 24 patients (32%) were given aspirin, 100 mg/die, for previous thrombosis or microvascular symptoms. No cytotoxic drugs were given. The IE cohort was followed in the outpatient clinic with physical examination and full blood count at least every three months for a median period of 3.5 years (range 1–23). Twentythree patients (31%) were followed for more than 8 years. No patient was lost to follow-up. During the observation period, no disease potentially associated with secondary eryhtrocytosis emerged and no hematological transition into overt PV, myelofibrosis or acute leukemia occurred; two patients had a major thrombotic event (1 cerebral ischemia and 1 deep vein thrombosis) with an estimated incidence of thrombotic complications of 0.8% patient-year. The incidence of thrombosis was significantly lower than observed in 205 patients with overt PV followed during the same period in one of the two institutions (Bergamo, 3.49% patient-year, p<0.05). This study indicates that: a. the natural history of patients with IE, at least in the first years, is characterized by a remarkable and unexpected homogeneity without appearance of overt PV or diseases associated with secondary erythrocythosis; b. the diagnosis of IE identifies a group of absolute erythrocythoses at lower risk of thrombotic complications not requiring cytotoxic drug therapy; c. the diagnostic work-up of patients with absolute erythrocythosis should carefully distinguish IE from PV because the natural history and management of the two diseases is different.

Atypical venous thromboses in myeloproliferative neoplasias

Phlebologie ◽  
2015 ◽  
Vol 44 (06) ◽  
pp. 324-329
Author(s):  
C. Dicke ◽  
A. Frölich ◽  
K. Holstein ◽  
C. Bokemeyer ◽  
F. Langer
Keyword(s):  
Platelet Count ◽  
Deep Vein Thrombosis ◽  
Sinus Thrombosis ◽  
Jak2 V617f ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus Thrombosis ◽  
Vein Thrombosis ◽  
Thrombotic Complications ◽  
Deep Vein ◽  
Venous Thromboses

SummaryWe describe two patients who developed an extensive catheter-related upper extremity deep vein thrombosis and a cerebral venous sinus thrombosis, respectively. Both thrombotic complications occurred in the presence of an elevated platelet count. Subsequent detection of the JAK2 V617F and MPL mutations led to the diagnosis of a myeloproliferative neoplasia.

Sign in / Sign up

Export Citation Format

Share Document