Clinico-Demographic Analysis and Outcome of Childhood Thrombosis in a Pediatric Hematology-Oncology Unit: A single Center Experience

Abstract

Aim of the Study: Thrombosis is rare in childhood with limited studies. Our retrospective study was designed to evaluate children with documented thrombotic events registered in our pediatric hematology -oncology unit over the last 3 years as regards clinical features, etiology, management and outcomes. Methods: Among 963 newly registered, 30 patients (16 females and 14 males, median age 4.5 years) with clinical and radiological evidence of thrombosis were identified. Data collection included clinical presentation, identifiable risk factors, thrombophilia screening, radiologic investigations, treatment and outcome. Results: Age at first thrombotic event was higher for patients with secondary than primary etiology (p=0.018). In 66.7% of patients, there was at least one identified risk for thrombosis, and cancer chemotherapy was the most frequent etiology. Inherited thrombophilia were proven in 13.3%. Secondary thrombophilia presented mostly with neurological symptoms (70%) while inherited thrombophilias with purpura fulminans (80%) (p=0.001). The recurrence was higher with primary (30%) compared to secondary thrombophilias (10%). Patients' outcome included neurologic deficit (26.7%), recurrence (16.7%), amputation (6.7%) and death (16.7%). Conclusion: Thrombosis secondary to an acquired risk factor occurred at older age, commonly presented by central thrombosis with no significant difference between primary and secondary thrombosis in the residual effects. Further studies are warranted to determine proper duration of anticoagulant therapy to prevent recurrence.