Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years

Publication Date:
2018-06-01
Publisher:
American Society of Hematology (ASH)
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
Medicine
Keywords:
Thrombosis and Hemostasis, Lymphoid Neoplasia, Clinical Trials and Observations
Published by:
http://www.hematology.org/
_version_ 1836398951878623233
autor Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
beschreibung Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during the treatment of 1772 consecutive Nordic/Baltic patients with ALL aged 1 to 45 years who were treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol (July 2008-April 2017). The 2.5-year cumulative incidence of thromboembolism (N = 137) was 7.9% (95% confidence interval [CI], 6.6-9.1); it was higher in patients aged at least 10 years ( P 〈 .0001). Adjusted hazard ratios (HRas) were associated with greater age (range, 10.0-17.9 years: HRa, 4.9 [95% CI, 3.1-7.8; P 〈 .0001]; 18.0-45.9 years: HRa, 6.06 [95% CI, 3.65-10.1; P 〈 .0001]) and mediastinal mass at ALL diagnosis (HRa, 2.1; 95% CI, 1.0-4.3; P = .04). In a multiple absolute risk regression model addressing 3 thromboembolism risk factors, age at least 10 years had the largest absolute risk ratio (RR age , 4.7 [95% CI, 3.1-7.1]; RR enlarged lymph nodes , 2.0 [95% CI, 1.2-3.1]; RR mediastinal mass , 1.6 [95% CI, 1.0-2.6]). Patients aged 18.0 to 45.9 years had an increased hazard of pulmonary embolism (HRa, 11.6; 95% CI, 4.02-33.7; P 〈 .0001), and patients aged 10.0 to 17.9 years had an increased hazard of cerebral sinus venous thrombosis (HRa, 3.3; 95% CI, 1.5-7.3; P = .003) compared with children younger than 10.0 years. Asparaginase was truncated in 38/128 patients with thromboembolism, whereas thromboembolism diagnosis was unassociated with increased hazard of relapse ( P = .6). Five deaths were attributable to thromboembolism, and patients younger than 18.0 years with thromboembolism had increased hazard of dying compared with same-aged patients without thromboembolism (both P ≤ .01). In conclusion, patients aged at least 10 years could be candidates for preemptive antithrombotic prophylaxis. However, the predictive value of age 10 years or older, enlarged lymph nodes, and mediastinal mass remain to be validated in another cohort.
citation_standardnr 6272595
datenlieferant ipn_articles
feed_id 310
feed_publisher American Society of Hematology (ASH)
feed_publisher_url http://www.hematology.org/
insertion_date 2018-06-01
journaleissn 1528-0020
journalissn 0006-4971
publikationsjahr_anzeige 2018
publikationsjahr_facette 2018
publikationsjahr_intervall 7984:2015-2019
publikationsjahr_sort 2018
publisher American Society of Hematology (ASH)
quelle Blood
relation http://www.bloodjournal.org/cgi/content/short/131/22/2475?rss=1
schlagwort Thrombosis and Hemostasis, Lymphoid Neoplasia, Clinical Trials and Observations
search_space articles
shingle_author_1 Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
shingle_author_2 Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
shingle_author_3 Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
shingle_author_4 Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
shingle_catch_all_1 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
Thrombosis and Hemostasis, Lymphoid Neoplasia, Clinical Trials and Observations
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during the treatment of 1772 consecutive Nordic/Baltic patients with ALL aged 1 to 45 years who were treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol (July 2008-April 2017). The 2.5-year cumulative incidence of thromboembolism (N = 137) was 7.9% (95% confidence interval [CI], 6.6-9.1); it was higher in patients aged at least 10 years ( P < .0001). Adjusted hazard ratios (HRas) were associated with greater age (range, 10.0-17.9 years: HRa, 4.9 [95% CI, 3.1-7.8; P < .0001]; 18.0-45.9 years: HRa, 6.06 [95% CI, 3.65-10.1; P < .0001]) and mediastinal mass at ALL diagnosis (HRa, 2.1; 95% CI, 1.0-4.3; P = .04). In a multiple absolute risk regression model addressing 3 thromboembolism risk factors, age at least 10 years had the largest absolute risk ratio (RR age , 4.7 [95% CI, 3.1-7.1]; RR enlarged lymph nodes , 2.0 [95% CI, 1.2-3.1]; RR mediastinal mass , 1.6 [95% CI, 1.0-2.6]). Patients aged 18.0 to 45.9 years had an increased hazard of pulmonary embolism (HRa, 11.6; 95% CI, 4.02-33.7; P < .0001), and patients aged 10.0 to 17.9 years had an increased hazard of cerebral sinus venous thrombosis (HRa, 3.3; 95% CI, 1.5-7.3; P = .003) compared with children younger than 10.0 years. Asparaginase was truncated in 38/128 patients with thromboembolism, whereas thromboembolism diagnosis was unassociated with increased hazard of relapse ( P = .6). Five deaths were attributable to thromboembolism, and patients younger than 18.0 years with thromboembolism had increased hazard of dying compared with same-aged patients without thromboembolism (both P ≤ .01). In conclusion, patients aged at least 10 years could be candidates for preemptive antithrombotic prophylaxis. However, the predictive value of age 10 years or older, enlarged lymph nodes, and mediastinal mass remain to be validated in another cohort.
Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
American Society of Hematology (ASH)
0006-4971
00064971
1528-0020
15280020
shingle_catch_all_2 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
Thrombosis and Hemostasis, Lymphoid Neoplasia, Clinical Trials and Observations
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during the treatment of 1772 consecutive Nordic/Baltic patients with ALL aged 1 to 45 years who were treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol (July 2008-April 2017). The 2.5-year cumulative incidence of thromboembolism (N = 137) was 7.9% (95% confidence interval [CI], 6.6-9.1); it was higher in patients aged at least 10 years ( P < .0001). Adjusted hazard ratios (HRas) were associated with greater age (range, 10.0-17.9 years: HRa, 4.9 [95% CI, 3.1-7.8; P < .0001]; 18.0-45.9 years: HRa, 6.06 [95% CI, 3.65-10.1; P < .0001]) and mediastinal mass at ALL diagnosis (HRa, 2.1; 95% CI, 1.0-4.3; P = .04). In a multiple absolute risk regression model addressing 3 thromboembolism risk factors, age at least 10 years had the largest absolute risk ratio (RR age , 4.7 [95% CI, 3.1-7.1]; RR enlarged lymph nodes , 2.0 [95% CI, 1.2-3.1]; RR mediastinal mass , 1.6 [95% CI, 1.0-2.6]). Patients aged 18.0 to 45.9 years had an increased hazard of pulmonary embolism (HRa, 11.6; 95% CI, 4.02-33.7; P < .0001), and patients aged 10.0 to 17.9 years had an increased hazard of cerebral sinus venous thrombosis (HRa, 3.3; 95% CI, 1.5-7.3; P = .003) compared with children younger than 10.0 years. Asparaginase was truncated in 38/128 patients with thromboembolism, whereas thromboembolism diagnosis was unassociated with increased hazard of relapse ( P = .6). Five deaths were attributable to thromboembolism, and patients younger than 18.0 years with thromboembolism had increased hazard of dying compared with same-aged patients without thromboembolism (both P ≤ .01). In conclusion, patients aged at least 10 years could be candidates for preemptive antithrombotic prophylaxis. However, the predictive value of age 10 years or older, enlarged lymph nodes, and mediastinal mass remain to be validated in another cohort.
Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
American Society of Hematology (ASH)
0006-4971
00064971
1528-0020
15280020
shingle_catch_all_3 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
Thrombosis and Hemostasis, Lymphoid Neoplasia, Clinical Trials and Observations
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during the treatment of 1772 consecutive Nordic/Baltic patients with ALL aged 1 to 45 years who were treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol (July 2008-April 2017). The 2.5-year cumulative incidence of thromboembolism (N = 137) was 7.9% (95% confidence interval [CI], 6.6-9.1); it was higher in patients aged at least 10 years ( P < .0001). Adjusted hazard ratios (HRas) were associated with greater age (range, 10.0-17.9 years: HRa, 4.9 [95% CI, 3.1-7.8; P < .0001]; 18.0-45.9 years: HRa, 6.06 [95% CI, 3.65-10.1; P < .0001]) and mediastinal mass at ALL diagnosis (HRa, 2.1; 95% CI, 1.0-4.3; P = .04). In a multiple absolute risk regression model addressing 3 thromboembolism risk factors, age at least 10 years had the largest absolute risk ratio (RR age , 4.7 [95% CI, 3.1-7.1]; RR enlarged lymph nodes , 2.0 [95% CI, 1.2-3.1]; RR mediastinal mass , 1.6 [95% CI, 1.0-2.6]). Patients aged 18.0 to 45.9 years had an increased hazard of pulmonary embolism (HRa, 11.6; 95% CI, 4.02-33.7; P < .0001), and patients aged 10.0 to 17.9 years had an increased hazard of cerebral sinus venous thrombosis (HRa, 3.3; 95% CI, 1.5-7.3; P = .003) compared with children younger than 10.0 years. Asparaginase was truncated in 38/128 patients with thromboembolism, whereas thromboembolism diagnosis was unassociated with increased hazard of relapse ( P = .6). Five deaths were attributable to thromboembolism, and patients younger than 18.0 years with thromboembolism had increased hazard of dying compared with same-aged patients without thromboembolism (both P ≤ .01). In conclusion, patients aged at least 10 years could be candidates for preemptive antithrombotic prophylaxis. However, the predictive value of age 10 years or older, enlarged lymph nodes, and mediastinal mass remain to be validated in another cohort.
Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
American Society of Hematology (ASH)
0006-4971
00064971
1528-0020
15280020
shingle_catch_all_4 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
Thrombosis and Hemostasis, Lymphoid Neoplasia, Clinical Trials and Observations
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during the treatment of 1772 consecutive Nordic/Baltic patients with ALL aged 1 to 45 years who were treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol (July 2008-April 2017). The 2.5-year cumulative incidence of thromboembolism (N = 137) was 7.9% (95% confidence interval [CI], 6.6-9.1); it was higher in patients aged at least 10 years ( P < .0001). Adjusted hazard ratios (HRas) were associated with greater age (range, 10.0-17.9 years: HRa, 4.9 [95% CI, 3.1-7.8; P < .0001]; 18.0-45.9 years: HRa, 6.06 [95% CI, 3.65-10.1; P < .0001]) and mediastinal mass at ALL diagnosis (HRa, 2.1; 95% CI, 1.0-4.3; P = .04). In a multiple absolute risk regression model addressing 3 thromboembolism risk factors, age at least 10 years had the largest absolute risk ratio (RR age , 4.7 [95% CI, 3.1-7.1]; RR enlarged lymph nodes , 2.0 [95% CI, 1.2-3.1]; RR mediastinal mass , 1.6 [95% CI, 1.0-2.6]). Patients aged 18.0 to 45.9 years had an increased hazard of pulmonary embolism (HRa, 11.6; 95% CI, 4.02-33.7; P < .0001), and patients aged 10.0 to 17.9 years had an increased hazard of cerebral sinus venous thrombosis (HRa, 3.3; 95% CI, 1.5-7.3; P = .003) compared with children younger than 10.0 years. Asparaginase was truncated in 38/128 patients with thromboembolism, whereas thromboembolism diagnosis was unassociated with increased hazard of relapse ( P = .6). Five deaths were attributable to thromboembolism, and patients younger than 18.0 years with thromboembolism had increased hazard of dying compared with same-aged patients without thromboembolism (both P ≤ .01). In conclusion, patients aged at least 10 years could be candidates for preemptive antithrombotic prophylaxis. However, the predictive value of age 10 years or older, enlarged lymph nodes, and mediastinal mass remain to be validated in another cohort.
Rank, C. U., Toft, N., Tuckuviene, R., Grell, K., Nielsen, O. J., Frandsen, T. L., Marquart, H. V. H., Albertsen, B. K., Tedgard, U., Hallböök, H., Ruud, E., Jarvis, K. B., Quist-Paulsen, P., Huttunen, P., Wartiovaara-Kautto, U., Jonsson, O. G., Trakymiene, S. S., Griskevicius, L., Saks, K., Punab, M., Schmiegelow, K.
American Society of Hematology (ASH)
0006-4971
00064971
1528-0020
15280020
shingle_title_1 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
shingle_title_2 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
shingle_title_3 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
shingle_title_4 Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
timestamp 2025-06-30T23:35:15.007Z
titel Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
titel_suche Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years
topic W
WW-YZ
uid ipn_articles_6272595