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    Oral Communication

    Pediatrics

    The Spectrum of Pediatric Bleeding and Clotting: From Genes to Long-Term Related Outcomes

    OC 48.4 - The Throm-PED registry: epidemiology and treatment of adolescent thrombosis

    Monday, June 26, 2023
    15:30 – 15:45 ET
    Room: 518
    Session Available As: On-Demand

      Presenting Author(s)

    • C. Heleen Van Ommen, MD, PhD (she/her/hers)

      Head dept. Pediatric Hematology & Oncology
      Erasmus MC Sophia Children's Hospital
      Rotterdam, Zuid-Holland, Netherlands

      • Co-Author(s)

    • Leslie Raffini, MD, MSCE (she/her/hers)

      Medical Director of the Hemostasis and Thrombosis Center
      Children's Hospital of Philadelphia
      Philadelphia, Pennsylvania, United States

    • Rukhmi Bhat, MD,MS, DNB

      Associate Professor of Pediatrics (Hematology, Oncology, and Stem Cell Transplantation)
      Ann & Robert H. Lurie Children's Hospital
      Chicago, Illinois, United States

    • Rubén Berrueco, PhD

      Head of Department. Pediatric Hematology
      Hospital Sant Joan de Déu
      Esplugues Llobregat, Catalonia, Spain

    • MB

      Mohammad Bordbar

      Pediatric Hematologist-Oncologist
      Shiraz University
      Chiraz, Fars, Iran

    • Carolina Cervio, MD (she/her/hers)

      staff Pediatric Hematologist
      Hospital de Pediatría "Prof. Dr. Juan P. Garrahan"
      Buenos Aires, Buenos Aires, Argentina

    • MS

      Mindy L. Simpson

      Medical Director
      Rush University Medical Center, Rush Hemophilia and Thrombophilia Center, Chicago, IL, USA
      chicago, Illinois, United States

    • Nongnuch Sirachainan, MD

      Prof.
      Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
      Bangkok, Krung Thep, Thailand

    • JJ

      Julie Jaffray

      Pediatric Hematologist-Oncologist
      Rady Children's Hospital
      San Diego, California, United States

    • SS

      Surbhi Saini

      Assistant Professor of Pediatrics, Hematology and Oncology
      Department of Pediatrics, Washington University in St. Louis
      St. Louis, Missouri, United States

    • BB

      Brian Branchford

      Pediatric Hematologist-Oncologist
      Versiti Medical Sciences Institute
      Wauwatosa, Wisconsin, United States

    • Mihir D. Bhatt, MD, MSc (he/him/his)

      Pediatric Hematologist
      McMaster Children’s Hospital, McMaster University
      Hamilton, Ontario, Canada

    • Riten Kumar, MD, MSc

      Associate Professor of Pediatrics
      Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Harvard Medical School
      Boston, Massachusetts, United States

    • Assaf Barg, MD

      Pediatric Hematologist
      The National Hemophilia Center, and Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Ramat Gan, Israel
      Tel Aviv, HaMerkaz, Israel

    • JB

      Jan Blatny

      Director of Haemophilia Comprehensive Care centre
      Children’s University Hospital Brno
      Brno, Moravskoslezsky kraj, Czech Republic

    • PZ

      Pavel Zharkov

      Pediatric Hematologist-Oncologist
      Dmitry Rogachev National Research Center
      Moscou, Moskva, Russia

    • Rungrote Natesirinilkul, MD

      Associate Professor
      Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
      Chiang Mai, Chiang Mai, Thailand

    • Natalie A. Montanez, FNP-C, CACP

      Nurse Practitioner, Certified Anticoagulation Care Provider
      University of Texas Health Science Center of Houston, McGovern Medical School, Gulf States Hemophilia and Thrombophilia Center, Houston, Texas
      Houston, Texas, United States

    • Paul Monagle, MD

      Professor
      Haematology Research, Murdoch Children's Research Institute
      Melbourne, Victoria, Australia

    • LS

      Lakshmi Srivaths

      Professor of Pediatrics, Division of Hematology
      University of Texas Health Science Center of Houston, McGovern Medical School, Gulf States Hemophilia and Thrombophilia Center
      Houston, Texas, United States

    Background: Pediatric venous thromboembolism (VTE) has a bimodal age distribution with peaks noted in infancy and adolescent years. Few studies have investigated the epidemiology and specific management of VTE in adolescents.

    Aims: To evaluate the epidemiology and management of VTE in adolescents in comparison to younger children.

    Methods: The Throm-PED registry is an international, multicenter, prospective disease registry of the International Pediatric Thrombosis Network (IPTN). In the basic VTE registry the following data are prospectively collected: age at diagnosis, gender, VTE type, location, risk factors and treatment. Categorical variables were compared using the chi-square or Fisher exact test, as applicable, using SPSS software.

    Results: Since inception of the registry in 2019, 1191 children (≤18 years; n=608 male) with VTE have been included. The median age at VTE diagnosis was 5 years, 420 patients (35%) were ≥12 years old (adolescent cohort). More female patients were present in the adolescent cohort compared to the younger cohort. (Table 1) In the adolescent cohort, VTE was more frequently located in the lung and upper extremity, and less frequently in the brain, jugular vein and inferior vena cava than in the younger cohort. VTE risk factors that were more often present in adolescents included immobility, oral contraception, COVID-19 infection, obesity and congenital thrombophilia, whereas central venous catheters, non COVID-19 infection and congenital heart disease were less common. Most adolescents received antithrombotic treatment. Direct oral anticoagulants, vitamin K antagonists and thrombolysis were more often administered to adolescents than younger children.

    Conclusion(s): Epidemiology and treatment were different in adolescents compared to younger children. More detailed evaluation of adolescent thrombosis will help to develop tailored preventive and management strategies in this age group.

    Learning Objectives:

    • describe the epidemiology of venous thromboembolic disease in adolescent patients
    • describe the current management of venous thromboembolic disease in adolescent patients
    • identify the differences in epidemiology and management of venous thrombosis between adolescents and other age groups