Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
Pediatric Oncology, Skåne University Hospital, Lund University, Sweden.
Thromb Res. 2017 Apr;152:64-68. doi: 10.1016/j.thromres.2017.02.011. Epub 2017 Feb 16.
Pediatric patients with Hodgkin lymphoma (HL) have several risk factors for venous thromboembolism (VTE). Although these patients are occasionally treated with thromboprophylaxis, no guidelines are implemented in Sweden. Scarce data from adult patients indicate an increased risk of VTE, but pediatric data is largely missing. Given the favorable overall survival of HL, there should reasonably be more focus on preventing complications.
We conducted a retrospective cohort study, including all patients registered in the Childhood Cancer Registry under the age of 18years diagnosed with HL between January 2005 and December 2015 in Sweden.
Data was retrieved from the medical records of all 163 patients (100%) at six Swedish pediatric cancer centers. The incidence of VTE was 7.7% (symptomatic VTE 3.9%). The median follow-up was 3.4years (range 0.3-10.5). Only five patients (3.1%) were treated with thromboprophylaxis. All VTE events occurred in the older age category (11-17years) and all but one (92.7%) had a mediastinal mass. While the VTE did not significantly affect the treatment of HL, it caused increased morbidity and 2/12 developed a post-thrombotic syndrome. No significant risk factors for VTE were identified.
VTE is a relatively common complication of HL and its treatment, causing increased acute and long-term morbidity. However, due to limited number of events we could not demonstrate risk-factors for VTE that would identify patients who might benefit from thromboprophylaxis.
患有霍奇金淋巴瘤（HL）的儿科患者存在多种静脉血栓栓塞（VTE）的风险因素。尽管这些患者偶尔会接受血栓预防治疗，但瑞典并未实施相关指南。来自成人患者的稀缺数据表明 VTE 风险增加，但儿科数据则大量缺失。鉴于 HL 的总体生存率良好，应更加关注预防并发症。
我们进行了一项回顾性队列研究，纳入了瑞典在 2005 年 1 月至 2015 年 12 月期间登记在儿童癌症登记处、年龄在 18 岁以下且诊断为 HL 的所有患者。
从瑞典六家儿科癌症中心的所有 163 名患者（100%）的病历中检索到数据。VTE 的发生率为 7.7%（有症状的 VTE 为 3.9%）。中位随访时间为 3.4 年（范围 0.3-10.5 年）。仅有 5 名患者（3.1%）接受了血栓预防治疗。所有 VTE 事件均发生在年龄较大的类别（11-17 岁）中，且除 1 例外（92.7%）均有纵隔肿块。虽然 VTE 并未显著影响 HL 的治疗，但它导致了更高的发病率，且 2/12 例发展为血栓后综合征。未确定 VTE 的显著危险因素。
VTE 是 HL 及其治疗的一个相对常见的并发症，导致急性和长期发病率增加。然而，由于事件数量有限，我们无法证明 VTE 的风险因素可确定可能受益于血栓预防治疗的患者。
