Sivaslioglu et al identified risk factors for thrombosis in pediatric patients with acute lymphoblastic leukemia (ALL). These can help to identify a patient who may benefit from interventions to reduce the risk. The authors are from Ankara Etlik Zubeyde Hanim Women's and Maternal Training and Research Hospital and Gazi University in Turkey.
Patient selection: pediatric patient with ALL, from 1 to 15 years of age
Sites of thromboemboli: right atrium, jugular vein, subclavian vein, brachiocephalic vein, stroke. The locations suggest association with an intravascular catheter.
Risk factors for thrombosis:
(1) age >= 10 years of age
(2) intravascular catheter
(3) Factor V Leiden mutation
(4) prednisolone therapy
Factor V Leiden mutations in the population were heterozygous. Homozygous patients would problably be more severely affected.
Dexamethasone may be preferrable to prednisolone.
Other hereditary hypercoagulable states - methyleneterahydrofolate reductase (MTHFR), prothrombin 20210A and lipoprotein A - were not significant predictors of thrombosis in the study. However, they might be significant in a larger study.
