The International Society on Thrombosis and Hemostasis has released guidance on identifying at-risk patients and preventing venous thromboembolism in pediatric cancer. Among the recommendations:
- Perform comprehensive risk assessment on each pediatric cancer patient at the initiation of cancer therapy.
- Do not administer routine primary thromboprophylaxis in pediatric cancer patients without a history of prior thrombosis.
- Administer thromboprophylaxis in pediatric cancer patients with prior thrombosis who are continuing to receive intensive therapy, as long as there are no anticoagulation contraindications.
- Consider thromboprophylaxis on a case-by-case basis for pediatric cancer patients with no history of VTE, but with significant combinations of risk factors, including central venous catheters, asparaginase therapy, obesity, adolescence, hormonal contraceptives, or hospitalization for surgery.
Tullius B, Athale U, van Ommen C, Chan A, Palumbo J, Balagtas J. The identification of at-risk patients and prevention of venous thromboembolism in pediatric cancer: Guidance from the SSC of the ISTH. [Published online ahead of print November 27, 2017]. J Thromb Haemost. doi:10.1111/jth.13895.
This Week's Must Reads
Intensity modulated radiation therapy may be preferable in children with extremity nonrhabdomyosarcoma soft-tissue sarcomas, Source: Rao A et al. Intl J Rad Oncology*Biology*Physics; Jan. 2019, 38-44. https://doi.org/10.1016/j.ijrobp.2018.09.005
Thrombolysis for acute ischemic stroke safe in GI malignancy, Inohara T et al. Circulation. 2018 Nov 6;138[suppl 1], Abstract A12291
Ten years of anastrozole boosts disease-free survival, Ohtani S et al. SABCS 2018, Abstract GS3-04
Outcomes better in TNBC with adjuvant chemotherapy within 30 days of surgery, Morante Z et al., SABCS 2018 Abstract GS2-05
TAO: Nonwhite ethnicity, limb infection predict poor prognosis, Le Joncour A et al. Arthritis Rheumatol. 2018;70(Suppl 10): Abstract 1885
Must Reads in Bleeding Disorders
FDA draft guidance on platelet safety, FDA Draft Guidance, December 2018
HemoTypeSC offers rapid sickle cell detection, Serrao E et al. ASH 2018, Abstract LBA-3
Impact of RBC transfusion limits, Roubinian NH et al. Ann Intern Med. 2018 Dec 18. doi: 10.7326/M17-3253
Early results for novel hemophilia A infusion, Chowdary P et al. ASH 2018, Abstract 489
Diagnostic challenges in hemophilia A, Patil R et al. Thromb Res. 2018 Dec;172:29-35