Publications by authors named "Irene L M Klaassen"

The rising incidence of venous thromboembolism (VTE) in neonates has led to increased use of low-molecular-weight heparins (LMWHs), but optimal dosages remain uncertain. A serious adverse effect of LMWHs is major bleeding. Given the vulnerability of neonates to major bleeding, we aimed to review therapeutic and prophylactic LMWH dosages to achieve target anti-factor Xa ranges of 0.

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Patients with thrombophilia show a higher incidence of VTE due to a disturbance in the hemostatic system. Hereditary thrombophilia can be identified by laboratory diagnostics, however most guidelines advise against thrombophilia testing in the majority of the patients with VTE, since the outcome rarely affects clinical decisions for the treatment. In this article we describe two cases in which hereditary thrombophilia testing could be considered.

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Background: Pediatric arterial ischemic stroke (AIS) is a rare disorder, associated with severe morbidity. In adults, elevated lipoprotein(a) (Lp(a)), a cholesterol-like particle, is associated with ischemic stroke. However, data on Lp(a) and pediatric AIS are scarce.

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 Venous thromboembolism (VTE) is an important complication for treatment of acute lymphoblastic leukemia (ALL) in children. Especially, ALL treatment, with therapeutics such as asparaginase and steroids, increases the thrombotic risk by reduction in procoagulant and anticoagulant proteins. Replacement of deficient natural anticoagulants by administration of fresh frozen plasma (FFP) may have a preventive effect on the occurrence of VTE.

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Background: Venous thromboembolism (VTE) is relatively common in children with acute lymphoblastic leukemia (ALL). Thrombotic risk factors in ALL are asparaginase and steroids. However, within the ALL populations treated on the same regimen, it is less clear which other risk factors play a role.

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The incidence of venous thromboembolism (VTE) in children is rising. Hence, there is an increasing off-label use of low-molecular-weight heparin (LMWH). There is little data about therapeutic and prophylactic LWMH dosages, and their safety and efficacy.

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Venous thromboembolism (VTE) is a serious complication in paediatric oncology patients. To identify the incidence, risk factors and recurrence rate of VTE in paediatric oncology patients, an observational, retrospective cohort study of all consecutive children (≤18 years) with malignancies, treated at the Emma Children's Hospital Academic Medical Centre between January 1989 and December 2013, was done. A matched case-control study in children with lymphomas was performed, to identify thrombotic risk factors.

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Article Synopsis
  • Venous thromboembolism (VTE) is a serious issue during acute lymphoblastic leukemia (ALL) treatment, often worsened by the use of asparaginase, prompting the need for preventive measures.
  • A new randomized controlled trial named TropicALL will study the effectiveness and safety of using high doses of low-molecular-weight heparin (LMWH) as thromboprophylaxis against not using it in children aged 1-19 with primary ALL, receiving asparaginase treatment.
  • The trial aims to enroll 324 patients to examine VTE rates and bleeding risks, establishing it as the first thorough evaluation of LMWH prophylaxis in this specific context of pediatric leukemia treatment.
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The etiology of pediatric venous thromboembolic disease (VTE) is multifactorial, and in most children, 1 or more clinical risk factors are present. In addition, inherited thrombophilic disorders contribute to the development of pediatric VTE. In this review, the role of inherited thrombophilic disorders in the development of pediatric VTE, as well as the benefits and limitations of thrombophilia testing, will be discussed.

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