Thromboprophylaxis in paediatric acute lymphoblastic leukaemia

Mené dans 9 pays sur 512 patients pédiatriques atteints d'une leucémie lymphoblastique aiguë ou d'un lymphome (durée médiane de suivi : 27 jours), cet essai randomisé de phase III évalue l'intérêt de l'apoxaban pour prévenir une thromboembolie veineuse

Résumé en anglais

Thromboembolism is a serious complication in children with acute lymphoblastic leukaemia, resulting in morbidity, mortality, and adverse leukaemia outcomes. 1 , 2 , 3 Although thromboembolism is largely preventable, use of anticoagulants in children with acute lymphoblastic leukaemia is challenging since both the disease and myelosuppressive chemotherapy increase bleeding risk. Further, low molecular weight heparin (LMWH)—the preferred anticoagulant for children with cancer—is problematic for paediatric patients because it requires daily injections. 4 In the THROMBOTECT study, which compared prophylaxis with activity-dependent antithrombin supplements versus twice daily LMWH and low-dose unfractionated heparin infusion through a central venous line (CVL) in children (aged 1–18 years) undergoing induction therapy for acute lymphoblastic leukaemia (n=949), about 38% of patients declined to participate and 33% in the LMWH group switched to other groups.