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Venous thrombosis in children with solid tumors
Authors:Schiavetti Amalia  Foco Micaela  Ingrosso Annapaola  Bonci Enea  Conti Laura  Matrunola Marco
Affiliation:Department of Pediatrics, University La Sapienza, Institute Regina Elena, Rome, Italy. amalia.schiavetti@uniroma1.it
Abstract:
BACKGROUND: The prevalence of venous thrombosis (VT) in children with solid tumor and the role of different risk factors are not defined yet. AIM: A cross-sectional observational study was conducted to evaluate the prevalence of both symptomatic and asymptomatic catheter-associated thrombosis events in children affected with different solid tumors. METHODS: Patients with a solid tumor, admitted as day-care, were consecutively enrolled over a period of 10 months. All of them had a central venous line. Physical examination, D-dimer serum tests, and eco-color-Doppler ultrasonography were performed once at any time before catheter removal. RESULTS: Forty-two patients (14 females and 28 males)-mean age 115 months-were evaluated. Five of the 42 patients (12%) had VT. In 4 of these, VT was catheter-related: 3 asymptomatic and 1 symptomatic. In the last patient, VT was clinically symptomatic and not catheter related. Patients with longer duration of catheter insertion presented with a higher rate of VT (P=0.05). Moreover, patients affected with neuroblastoma showed a higher rate of VT than the others with different solid tumors (P<0.05). CONCLUSIONS: VT was visualized by echo-color-Doppler ultrasonography in 12% of the patients; it was asymptomatic in 7%. In our small series, VT was related to neuroblastoma disease and a longer duration of catheter insertion. Prospective and multicentric studies are required to select risk factors for VT in children with solid tumors.
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