Therapeutic aspects, determining the outcome of deep veins thrombosis (dvt) in children with hematological diseases

Abstract

Deep venous thrombosis (DVT) is a frequent complication in hospitalized children with hematological cancer. Antithrombotic therapy is a main treatment option in these cases, but there is still a lack of data on its influence on DVT outcomes in children. Objective: to compare the frequency of favorable and unfavorable outcomes of DVT in children with hematological and hemato-oncological diseases, depending on the antithrombotic therapy performed. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. 429 medical charts of patients, who received inpatient treatment in the Dmitry Rogachev National Research Center from 01/01/2013 - 12/31/17 were analyzed. There were used hemodynamic characteristics of DVT, also criteria for the correctness of management approach, therapy approach and criteria for DVT outcomes were developed. There were 122 symptomatic DVT (sDVT) and 408 asymptomatic DVT (aDVT). The treatment outcomes were analyzed in 424 (80%) cases of DVT, depending on the correctness of the therapy. In the group of sDVT, the number of favorable outcomes increases with correct therapy (66.7% for sDVT without treatment, 77.9% for treated sDVT, and 84.0% for sDVT, treated correctly, p < 0.05). In the group of aDVT there were no clear dependence between correctness of the treatment and thrombosis outcomes (45.2%, 57.9%, 57.2%, respectively, p = 0.09). Correctly performed antithrombotic treatment rises the favorable outcome rates by more than 20%. In contrast to sDVT, in cases of aDVT outcomes don't depend on therapy or its correctness. This fact could potentially rise the question of aDVT's nature and clinical significance. To determine the best therapy strategy, further research is needed.