Chen Yanxia, Fei Wenjing, Shi Yaqin, Ma Weiwei, Jiao Wei, Tao Fengqin, Zhu Jie, Wang Yuhai, Feng Xiaoyan
Department of Neurosurgery, The 904th Hospital of PLA, Medical School of Anhui Medical University, Wuxi, China.
Department of Critical Care Medicine, Institute of General Surgery, PLA Eastern Theater Command General Hospital, Nanjing, China.
Front Pediatr. 2025 Aug 12;13:1595223. doi: 10.3389/fped.2025.1595223. eCollection 2025.
Venous Thromboembolism (VTE) is a significant complication in pediatric high-grade glioma (pHGG) patients, impacting prognosis and treatment outcomes. Identifying unique risk factors and pathophysiology in children is essential for targeted prevention and treatment.
A multicenter retrospective analysis was conducted on pHGG patients enrolled between January 2012 and January 2024 at two hospitals. Data were collected from electronic medical records and follow-ups, focusing on VTE occurrence, clinical characteristics, and treatment outcomes. Statistical analyses included -tests, Mann-Whitney -tests, chi-square tests, and Cox regression models to identify risk factors and their impact on survival.
Out of 216 screened patients, 168 met the inclusion criteria. The mean age was 9.87 ± 3.67 years, with 37.5% experiencing VTE. Tumor volume, grade, and specific genetic mutations significantly influenced VTE occurrence. Anticoagulation therapy, Isocitrate Dehydrogenase 1 (IDH1) mutations, O6-Methylguanine-DNA Methyltransferase (MGMT) methylation, radiotherapy, chemotherapy, and prolonged bed rest were protective against VTE, while increased tumor volume, Grade 4 glioma, Epidermal Growth Factor Receptor (EGFR) positivity, p53 mutations, glucocorticoid therapy and central venous catheter placement (CVCP) placement promoted VTE risk. The median survival time was 51.4 months, and VTE occurrence negatively impacted patient prognosis.
This study highlights the risk factors for VTE in pHGG patients, emphasizing the need for tailored prevention and treatment strategies. The findings underscore the importance of clinical characteristics, genetic profiles, and treatment modalities in managing VTE and improving survival outcomes in pHGG.
静脉血栓栓塞症（VTE）是小儿高级别胶质瘤（pHGG）患者的一种重要并发症，会影响预后和治疗结果。识别儿童独特的风险因素和病理生理学对于针对性预防和治疗至关重要。
对2012年1月至2024年1月期间在两家医院登记的pHGG患者进行了多中心回顾性分析。从电子病历和随访中收集数据，重点关注VTE的发生情况、临床特征和治疗结果。统计分析包括t检验、曼-惠特尼U检验、卡方检验和Cox回归模型，以识别风险因素及其对生存的影响。
在216例筛查患者中，168例符合纳入标准。平均年龄为9.87±3.67岁，37.5%的患者发生了VTE。肿瘤体积、分级和特定基因突变显著影响VTE的发生。抗凝治疗、异柠檬酸脱氢酶1（IDH1）突变、O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）甲基化、放疗、化疗和长期卧床休息对VTE有预防作用，而肿瘤体积增大、4级胶质瘤、表皮生长因子受体（EGFR）阳性、p53突变、糖皮质激素治疗和中心静脉导管置入（CVCP）会增加VTE风险。中位生存时间为51.4个月，VTE的发生对患者预后有负面影响。
本研究强调了pHGG患者发生VTE的风险因素，强调了制定针对性预防和治疗策略的必要性。研究结果强调了临床特征、基因谱和治疗方式在管理VTE和改善pHGG患者生存结果方面的重要性。
