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Primary Thromboprophylaxis to Prevent Thrombotic Events in Pediatric Oncology Patients with a Malignant Mediastinal Mass.
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  • Susmita Sarangi,
  • Marian Gaballah,
  • Deirdre Nolfi-Donegan,
  • Maria Battaglia,
  • Seema Amin,
  • John Amodio,
  • Suchitra Acharya
Susmita Sarangi
MedStar Georgetown University Hospital
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Marian Gaballah
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Deirdre Nolfi-Donegan
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Maria Battaglia
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Seema Amin
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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John Amodio
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Suchitra Acharya
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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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.