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Venous thromboembolism in children with Hodgkin lymphoma – A population-based study in Sweden, Finland, and Denmark

Giertz, Mia ; Aarnivala, Henri ; Michelsen, Sascha W. ; Björklund, Caroline ; Grönroos, Marika ; Hjalgrim, Lisa L. ; Huttunen, Pasi ; Niinimäki, Riitta ; Pöyhönen, Tuuli and Raittinen, Päivi , et al. (2025) In Thrombosis Research 248.
Abstract

Background: Children and adolescents with Hodgkin lymphoma (HL) are susceptible to developing venous thromboembolism (VTE) due to several predisposing factors such as cancer itself, central venous catheter use, mediastinal mass, and glucocorticoid therapy, yet reports on the topic are scarce. Aim: To study incidence, risk factors, and treatment of VTE, and the use of thromboprophylaxis, in a retrospective clinical study on pediatric HL. Methods: Children under 18, diagnosed with HL 2005–2019 in Sweden, Denmark, and Finland were included. Data on patient characteristics, treatment, thrombotic events and follow up were collected from patients' medical records. Results: A total of 490 children were identified and data were assessed for... (More)

Background: Children and adolescents with Hodgkin lymphoma (HL) are susceptible to developing venous thromboembolism (VTE) due to several predisposing factors such as cancer itself, central venous catheter use, mediastinal mass, and glucocorticoid therapy, yet reports on the topic are scarce. Aim: To study incidence, risk factors, and treatment of VTE, and the use of thromboprophylaxis, in a retrospective clinical study on pediatric HL. Methods: Children under 18, diagnosed with HL 2005–2019 in Sweden, Denmark, and Finland were included. Data on patient characteristics, treatment, thrombotic events and follow up were collected from patients' medical records. Results: A total of 490 children were identified and data were assessed for 489. The cumulative 2-year incidence of VTE was 8.1 % (42/489). Older age at diagnosis (p = 0.004), mediastinal involvement (p = 0.024), and HL stage III + IV (p = 0.036) were significant risk factors for VTE. Children over 15 with mediastinal mass and HL stage III or IV had a 1-year cumulative incidence of VTE of 18 % and a nearly three-fold risk of developing VTE compared to all other patients (OR 2.94, 95 % CI 1.47–5.88, p = 0.002). The majority (39/42; 92.9 %) were treated with low-molecular-weight heparin. Four (9.5 %) patients developed post-thrombotic syndrome. Thromboprophylaxis was given to 18/489 (3.7 %) patients with HL, two of whom developed VTE. Conclusion: VTE is a common complication in adolescents treated for HL with large tumor burden at diagnosis. Prospective studies should focus on identifying patients who would benefit from thromboprophylaxis.

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Contribution to journal
publication status
published
subject
keywords
Hematology, Hemostasis, Hodgkin lymphoma, Lymphoma, Pediatric hematology, Thrombosis
in
Thrombosis Research
volume
248
article number
109287
publisher
Elsevier
external identifiers
  • scopus:85218463137
  • pmid:39993342
ISSN
0049-3848
DOI
10.1016/j.thromres.2025.109287
language
English
LU publication?
yes
id
b4b1631e-ba0b-46b6-bcc1-4def2bfea7eb
date added to LUP
2025-06-10 11:19:38
date last changed
2025-07-08 14:55:42
@article{b4b1631e-ba0b-46b6-bcc1-4def2bfea7eb,
  abstract     = {{<p>Background: Children and adolescents with Hodgkin lymphoma (HL) are susceptible to developing venous thromboembolism (VTE) due to several predisposing factors such as cancer itself, central venous catheter use, mediastinal mass, and glucocorticoid therapy, yet reports on the topic are scarce. Aim: To study incidence, risk factors, and treatment of VTE, and the use of thromboprophylaxis, in a retrospective clinical study on pediatric HL. Methods: Children under 18, diagnosed with HL 2005–2019 in Sweden, Denmark, and Finland were included. Data on patient characteristics, treatment, thrombotic events and follow up were collected from patients' medical records. Results: A total of 490 children were identified and data were assessed for 489. The cumulative 2-year incidence of VTE was 8.1 % (42/489). Older age at diagnosis (p = 0.004), mediastinal involvement (p = 0.024), and HL stage III + IV (p = 0.036) were significant risk factors for VTE. Children over 15 with mediastinal mass and HL stage III or IV had a 1-year cumulative incidence of VTE of 18 % and a nearly three-fold risk of developing VTE compared to all other patients (OR 2.94, 95 % CI 1.47–5.88, p = 0.002). The majority (39/42; 92.9 %) were treated with low-molecular-weight heparin. Four (9.5 %) patients developed post-thrombotic syndrome. Thromboprophylaxis was given to 18/489 (3.7 %) patients with HL, two of whom developed VTE. Conclusion: VTE is a common complication in adolescents treated for HL with large tumor burden at diagnosis. Prospective studies should focus on identifying patients who would benefit from thromboprophylaxis.</p>}},
  author       = {{Giertz, Mia and Aarnivala, Henri and Michelsen, Sascha W. and Björklund, Caroline and Grönroos, Marika and Hjalgrim, Lisa L. and Huttunen, Pasi and Niinimäki, Riitta and Pöyhönen, Tuuli and Raittinen, Päivi and Ranta, Susanna and Svahn, Johan E. and Törnudd, Lisa and Englund, Annika and Harila, Arja}},
  issn         = {{0049-3848}},
  keywords     = {{Hematology; Hemostasis; Hodgkin lymphoma; Lymphoma; Pediatric hematology; Thrombosis}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Thrombosis Research}},
  title        = {{Venous thromboembolism in children with Hodgkin lymphoma – A population-based study in Sweden, Finland, and Denmark}},
  url          = {{http://dx.doi.org/10.1016/j.thromres.2025.109287}},
  doi          = {{10.1016/j.thromres.2025.109287}},
  volume       = {{248}},
  year         = {{2025}},
}