TY - JOUR
T1 - Venous thromboembolism in children with Hodgkin lymphoma
T2 - A population-based study in Sweden, Finland, and Denmark
AU - Giertz, Mia
AU - Aarnivala, Henri
AU - Michelsen, Sascha W.
AU - Björklund, Caroline
AU - Grönroos, Marika
AU - Hjalgrim, Lisa L.
AU - Huttunen, Pasi
AU - Niinimäki, Riitta
AU - Pöyhönen, Tuuli
AU - Raittinen, Päivi
AU - Ranta, Susanna
AU - Svahn, Johan E.
AU - Törnudd, Lisa
AU - Englund, Annika
AU - Harila, Arja
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/4
Y1 - 2025/4
N2 - Background: Children and adolescents with Hodgkin lymphoma (HL) are susceptible to developing venous thromboembolism (VTE) due to several predisposing factors such as cancer itself, central venous catheter use, mediastinal mass, and glucocorticoid therapy, yet reports on the topic are scarce. Aim: To study incidence, risk factors, and treatment of VTE, and the use of thromboprophylaxis, in a retrospective clinical study on pediatric HL. Methods: Children under 18, diagnosed with HL 2005–2019 in Sweden, Denmark, and Finland were included. Data on patient characteristics, treatment, thrombotic events and follow up were collected from patients' medical records. Results: A total of 490 children were identified and data were assessed for 489. The cumulative 2-year incidence of VTE was 8.1 % (42/489). Older age at diagnosis (p = 0.004), mediastinal involvement (p = 0.024), and HL stage III + IV (p = 0.036) were significant risk factors for VTE. Children over 15 with mediastinal mass and HL stage III or IV had a 1-year cumulative incidence of VTE of 18 % and a nearly three-fold risk of developing VTE compared to all other patients (OR 2.94, 95 % CI 1.47–5.88, p = 0.002). The majority (39/42; 92.9 %) were treated with low-molecular-weight heparin. Four (9.5 %) patients developed post-thrombotic syndrome. Thromboprophylaxis was given to 18/489 (3.7 %) patients with HL, two of whom developed VTE. Conclusion: VTE is a common complication in adolescents treated for HL with large tumor burden at diagnosis. Prospective studies should focus on identifying patients who would benefit from thromboprophylaxis.
AB - Background: Children and adolescents with Hodgkin lymphoma (HL) are susceptible to developing venous thromboembolism (VTE) due to several predisposing factors such as cancer itself, central venous catheter use, mediastinal mass, and glucocorticoid therapy, yet reports on the topic are scarce. Aim: To study incidence, risk factors, and treatment of VTE, and the use of thromboprophylaxis, in a retrospective clinical study on pediatric HL. Methods: Children under 18, diagnosed with HL 2005–2019 in Sweden, Denmark, and Finland were included. Data on patient characteristics, treatment, thrombotic events and follow up were collected from patients' medical records. Results: A total of 490 children were identified and data were assessed for 489. The cumulative 2-year incidence of VTE was 8.1 % (42/489). Older age at diagnosis (p = 0.004), mediastinal involvement (p = 0.024), and HL stage III + IV (p = 0.036) were significant risk factors for VTE. Children over 15 with mediastinal mass and HL stage III or IV had a 1-year cumulative incidence of VTE of 18 % and a nearly three-fold risk of developing VTE compared to all other patients (OR 2.94, 95 % CI 1.47–5.88, p = 0.002). The majority (39/42; 92.9 %) were treated with low-molecular-weight heparin. Four (9.5 %) patients developed post-thrombotic syndrome. Thromboprophylaxis was given to 18/489 (3.7 %) patients with HL, two of whom developed VTE. Conclusion: VTE is a common complication in adolescents treated for HL with large tumor burden at diagnosis. Prospective studies should focus on identifying patients who would benefit from thromboprophylaxis.
KW - Hematology
KW - Hemostasis
KW - Hodgkin lymphoma
KW - Lymphoma
KW - Pediatric hematology
KW - Thrombosis
U2 - 10.1016/j.thromres.2025.109287
DO - 10.1016/j.thromres.2025.109287
M3 - Article
AN - SCOPUS:85218463137
SN - 0049-3848
VL - 248
JO - THROMBOSIS RESEARCH
JF - THROMBOSIS RESEARCH
M1 - 109287
ER -
