Sivaslioglu Selda, Gursel Turkiz, Kocak Ulker, Kaya Zuhre
Newborn Unit, Ankara Etlik Zübeyde Hanim Women's and Maternal Training and Research Hospital, Ankara, Turkey
The Pediatric Hematology Unit of the Department of Pediatrics, Medical School of Gazi University, Ankara, Turkey.
Clin Appl Thromb Hemost. 2014 Sep;20(6):651-3. doi: 10.1177/1076029612475022. Epub 2013 Jan 29.
We aimed to scrutinize the risk factors for thrombosis in children with acute lymphoblastic leukemia treated with the Berlin-Frankfurt-Münster 95 protocol. The study population was 82 children younger than 16 years of age. The children were followed up for 10 years until January 2007. Thrombosis occurred in 10 (12%) of 82 patients during the treatment course, mainly after the M protocol. The most common risk factor was factor V Leiden (FVL; 15.6%). This was followed by methyleneterahydrofolate reductase (MTHFR; 9.3%), elevated lipoprotein (1.5%), and prothrombin (PT) 20210A (1.5%) in descending order. The risk of thrombosis was found to be significantly high in patients with FVL mutation (odds ratio = 7.1, 95% confidence interval = 1.6-30.5). The risk of thrombosis was not significant in patients with MTHFR and PT20210A mutation (P = .2). Age, catheter usage, FVL mutation, and prednisolone treatment are significant risk factors for thromboemboli occurrence.
我们旨在仔细研究采用柏林 - 法兰克福 - 明斯特95方案治疗的急性淋巴细胞白血病患儿发生血栓形成的危险因素。研究对象为82名16岁以下儿童。对这些儿童进行了为期10年的随访，直至2007年1月。在治疗过程中，82例患者中有10例（12%）发生血栓形成，主要发生在M方案之后。最常见的危险因素是凝血因子V莱顿突变（FVL；15.6%）。其次依次是亚甲基四氢叶酸还原酶（MTHFR；9.3%）、脂蛋白升高（1.5%）和凝血酶原（PT）20210A（1.5%）。发现FVL突变患者发生血栓形成的风险显著升高（比值比 = 7.1，95%置信区间 = 1.6 - 30.5）。MTHFR和PT20210A突变患者发生血栓形成的风险不显著（P = 0.2）。年龄、使用导管、FVL突变和泼尼松龙治疗是血栓栓塞发生的重要危险因素。
