The Assessment of Risk Factors for Thrombosis in Children Treated for Non- Hodgkin Lymphoma

Thrombosis occurs quite frequently in patients with NHL, it is

a complication resulting from the presence of neoplastic disease and vascular catheter

and a side effect of the treatment (corticosteroids, L-asparaginase).

The aim of the study was to assess the factors predisposing to thrombosis in children

treated for non-Hodgkin's lymphomas.

6 cases of thrombosis in 31 children (19%) treated in the Department in 2007-2013 due to the NHL were analyzed. All patients with thrombosis were assesed: age of onset, location, cause of the thrombosis and the anticoagulant treatment. A analyzed patients underwent testing

for congenital thrombophilia.

Age at onset of thrombosis ranged from 2 to 17.5 years, median 9.5 years.

Arterial thrombosis occurred in 1 (17%), venous thrombosis in 5 (83%) patients. Thrombosis

occurred in 4 children with lymphoblastic lymphoma (LBL), 1 child with large cell anaplastic lymphoma (LCAL) and 1 child with primary mediastinal B-cell lymphoma (PMBCL). Most of the cases were concerned to central catheter (n = 5, 83%). Massive thrombosis

occurred in 2 children (33%). There was no recurrence of thrombosis. The most common

causes of thrombosis were: the presence of the central catheter (n = 5, 83%) and treatment with L-asparaginase (n = 4, 66%). The presence of mutation on the factor

V Leiden was discovered in 1 patient. 2 patients were treated with a recombinant tissue plasminogen activator in systemic infusion (16%), low molecular weight heparin was used

in 5 patients (83%), then changedd to warfarin in 3 (50%) children.

The bleeding complications of the treatment were not observed. All the children showed total

resolution of thrombi.

Conclusions:

1 The predominant location and cause of thrombosis in children with NHL is a central catheter

.2 Thrombosis occurs the most often in children with LBL.

3 The risk factor of thrombosis in children is the treatment with L-asparaginase

4 It was not found that congenital thrombophilia iss an additional risk factor for thrombosis

in children with NHL.

5 Thrombosis in children with NHL responds well to treatment with anticoagulants.