Thromboembolism in children with cancer: a retrospective multicenter study in Korea

  • Hyoung Soo Choi
  • Hye Jin Kim
  • Hyoung Jin Kang
  • Ji Won Lee
  • Hee Young Shin
  • Hyeon Jin Park
  • Byung-Kiu Park
  • Young Ho Lee
  • Jun Ah Lee
  • Yeon-Jung Lim
  • Kyung Duk ParkEmail author


Thromboembolism (TE) is a major cause of morbidity and mortality in adult cancer patients; however, there is a lack of sufficient knowledge on TE in pediatric cancer patients. We aimed to determine the epidemiology of TE in Korean children with cancer. Between January 2000 and July 2015, we retrospectively analyzed pediatric patients newly diagnosed with cancer at six tertiary hospitals in Korea. Of 3611 children with cancer, 33 (0.91%) had TE. A higher number of patients with acute lymphoblastic leukemia (n = 13), brain tumors (n = 6), lymphoma (n = 4), and bone/soft tissue sarcomas (n = 5) tended to develop TE. The male/female ratio was 17/16, and the median age at TE diagnosis was 10 years and 2 months. TE was detected a median of 2 months after cancer diagnosis. Symptoms including pain and swelling were present in 18 of the 33 patients. In terms of location, three intracerebral, 23 upper venous, six lower venous and one combined upper and lower venous system TEs were observed. Additional risk factors for TE included central venous catheter (CVC) use in 12 patients, steroid and/or L-asparaginase use in nine, and CVC and steroid and/or L-asparaginase use in seven. The TE incidence rate was quite low among Korean children with cancer, but higher than in the general pediatric population and among children hospitalized for diseases other than cancer. Further investigation of a larger pool of patients is warranted to determine the most effective strategies to prevent and treat TE in Korean children with cancer.


Thromboembolism Cancer Children Korea 



Acute lymphoblastic leukemia


Acute myeloid leukemia


Antithrombin III


Arterial thromboembolism


Central nervous system


Computed tomography


Central venous catheter


Low-molecular-weight heparin


Magnetic resonance imaging


Unfractionated heparin




Venous thromboembolism



This study was supported by a grant from the Seoul National University Bundang Hospital (SNUBH) Research Fund (Grant No.: 02-2013-047).

Compliance with ethical standards

Conflict of interest


Ethical approval

This study was approved by the Institutional Review Board of each participating institution and the Seoul National University Bundang Hospital (SNUBH) (IRB Approval No. B-1308/214-112). The need to obtain informed consent was waived by the board.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hyoung Soo Choi
    • 1
  • Hye Jin Kim
    • 1
  • Hyoung Jin Kang
    • 2
  • Ji Won Lee
    • 2
  • Hee Young Shin
    • 2
  • Hyeon Jin Park
    • 3
  • Byung-Kiu Park
    • 3
  • Young Ho Lee
    • 4
  • Jun Ah Lee
    • 5
  • Yeon-Jung Lim
    • 6
  • Kyung Duk Park
    • 2
    • 7
    Email author
  1. 1.Department of PediatricsSeoul National University Bundang HospitalSeongnamRepublic of Korea
  2. 2.Department of PediatricsSeoul National University HospitalSeoulRepublic of Korea
  3. 3.Center for Pediatric CancerNational Cancer CenterGoyangRepublic of Korea
  4. 4.Department of PediatricsHanyang University HospitalSeoulRepublic of Korea
  5. 5.Department of PediatricsKorea Cancer Center HospitalSeoulRepublic of Korea
  6. 6.Department of PediatricsChungnam National University HospitalDaejeonRepublic of Korea
  7. 7.Department of PediatricsChonbuk National University Medical SchoolJeonjuRepublic of Korea

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