Primary Thromboprophylaxis to Prevent Thrombotic Events in Pediatric
Oncology Patients with a Malignant Mediastinal Mass.
Abstract
Children with malignant mediastinal masses have increased thrombotic
events (TE). We examined primary thromboprophylaxis in reducing TE.
Eligible subjects were started on enoxaparin thromboprophylaxis and
compared to a cohort without. There were 15 TEs among 76 subjects for an
incidence of 19.7%. Mediastinal compression directly led to TE, (M-TE)
in 9.2% of subjects requiring 2-fold longer duration of therapeutic
anticoagulation. Primary thromboprophylaxis revealed a trend towards
reduction in M-TE although not statistically significant. The M-TE
subjects had greater superior vena caval compression at diagnosis
(p=0.033). We conclude that strategic thromboprophylaxis guided by
monitoring dynamic vascular compression can improve TE outcomes.