Prevalence of post-thrombotic syndrome following asymptomatic thrombosis in survivors of acute lymphoblastic leukemia.
BACKGROUND
Deep vein thrombosis (DVT) is a complication of treatment of acute lymphoblastic leukemia (ALL) in children but little is known about the long-term outcomes of these DVT.


OBJECTIVE
To determine the incidence of post-thrombotic syndrome (PTS) in (i) children with ALL diagnosed with asymptomatic DVT using radiographic testing and (ii) an unselected group of ALL survivors.


METHODS
Cross-sectional study in two populations. Group I comprised children in the Prophylactic Antithrombin Replacement in Kids with ALL treated with L-Asparaginase (PARKAA) study diagnosed with DVT by radiographic tests. Group II consisted of non-selected childhood ALL survivors <21 years. PTS was assessed using a standardized scoring sheet.


RESULTS
Group I: 13 PARKAA patients (median age 12 years) were assessed, and 7 had PTS (54%; 95% CI, 25-81). All patients had collaterals, three also had increased arm circumference. Group II: 41 patients (median age 13 years) with a history of ALL were enrolled, and 10 had PTS (24%; 95% CI, 11-38). All patients had collaterals; five also had increased arm circumference.


CONCLUSIONS
There is a high incidence of PTS in survivors of childhood ALL with radiographically diagnosed asymptomatic DVT. A significant proportion of ALL survivors develop PTS, indicating previously undiagnosed DVT.
Kuhle
S
S
Department of Pediatrics, Stollery Children's Hospital, Edmonton, AB, Canada.
Spavor
M
M
Massicotte
P
P
Halton
J
J
Cherrick
I
I
Dix
D
D
Mahoney
D
D
Bauman
M
M
Desai
S
S
Mitchell
L G
LG
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D020152:Antithrombin III Deficiency / Q000139:chemically induced; D001132:Arm / Q000098:blood supply / Q000473:pathology; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D017322:Clinical Trials, Phase II as Topic / Q000706:statistics & numerical data; D003097:Collateral Circulation; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D054070:Postthrombotic Syndrome / Q000453:epidemiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D017741:Survivors; D019851:Thrombophilia / Q000139:chemically induced; D020246:Venous Thrombosis / Q000150:complications* / Q000453:epidemiology
D001215:Asparaginase