vitamin-k-semiquinone-radical and Precursor-Cell-Lymphoblastic-Leukemia-Lymphoma

Thromboembolism (TE) is a well-recognized complication of pediatric cancer and can lead to mortality and excess morbidity. There is conflicting evidence about the effectiveness and safety of thromboprophylaxis in children. We conducted a systematic literature review and network meta-analysis of primary pharmacological thromboprophylaxis in children and adolescents (0-21 years) with cancer. The primary outcomes were objectively proven TE and major bleeding. The network meta-analysis included comparisons of multiple alternatives simultaneously: antithrombin (AT) replacement, low molecular weight heparin (LMWH), vitamin K antagonists (VKAs), and standard of care (SOC) defined as no thromboprophylaxis or low-dose heparin for catheter patency. Six articles describing 1,318 patients were included (mean age: 6.7 years, 56.7% male). Acute lymphoblastic leukemia was the underlying diagnosis in 97.5% of patients. All studies were considered at moderate or high risk of bias. LMWH was the only agent associated with lower odds of TE compared with SOC (odds ratio [OR]: 0.23, 95% confidence interval [CI]: 0.06-0.81). No statistically significant difference was detected between other thromboprophylaxis modalities and SOC. Tau

Topics: Adolescent; Anticoagulants; Antithrombins; Child; Child, Preschool; Female; Hemorrhage; Heparin, Low-Molecular-Weight; Humans; Infant; Infant, Newborn; Male; Neoplasms; Network Meta-Analysis; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Thromboembolism; Thrombosis; Vitamin K; Young Adult

To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers.. Population based case-control study with data abstracted from hospital records.. Scotland.. Children aged 0-14 years resident in Scotland from 1991-4 and diagnosed with leukaemia (150), lymphomas (46), central nervous system tumours (79), a range of other solid tumours (142), and a subset of acute lymphoblastic leukaemia (129). Controls were 777 children matched for age and sex, providing 417 matched sets (360 triplets and 57 pairs) for analysis.. Odds ratios for the risk of childhood leukaemia and cancer and intramuscular vitamin K versus a combined group of oral doses, none, and no record. Results are given for information recorded in medical notes and data supplemented by hospital policy.. Odds ratios based on medical record abstractions showed no significant positive association for leukaemias (odds ratio 1.30; 95% confidence interval 0.83 to 2.03), acute lymphoblastic leukaemia (1.21; 0.74 to 1.97), lymphomas (1.06; 0.46 to 2.42), central nervous system tumours (0.74; 0.40 to 1.34), and other solid tumours (0.59; 0.37 to 0.96). There was no association with acute lymphoblastic leukaemia in children aged 1 to 6 years. Imputation of exposure from hospital policy gave similar results. Adjustment for deprivation and type of delivery moved risk estimates closer to unity for all major diagnostic groups.. The observation of an increased risk of childhood leukaemia and cancer associated with intramuscular vitamin K is not confirmed by this independent population based study.

Topics: Adolescent; Case-Control Studies; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Injections, Intramuscular; Leukemia; Neoplasms; Odds Ratio; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Scotland; Vitamin K; Vitamin K Deficiency

Topics: Child; Child, Preschool; Humans; Infant; Infant, Newborn; Injections, Intramuscular; Leukemia; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Retrospective Studies; Risk Factors; Vitamin K