Primary Thromboprophylaxis to Prevent Thrombotic Events in Pediatric
Oncology Patients with a Malignant Mediastinal Mass.
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.