Finding pediatric thromboembolism: needles in a big data haystack

Thromboembolism is rare in healthy pediatric patients, but it is an increasing problem in children with underlying medical conditions such as cancer. The increase in childhood thromboembolism over the past decade is thought to be due to both heightened awareness of the diagnosis and more invasive technologies used in children with underlying medical conditions. 1 , 2 Understanding thromboembolism and developing safe treatment options for pediatric oncology patients is important due to the increased risk of death, organ dysfunction, and poor oncologic outcome. Consequences of thromboembolism also include increased hospital length of stay and cost. 3 Current published evidence on treatment for thromboembolism in the pediatric oncology population is limited, and published guidelines are often extrapolated from adult trials. 4 , 5 For example, in the 2018 guidelines released from the American Society of Hematology for treatment of thromboembolism in the pediatric population, although recommendations were made by a panel of experts, all the recommendations were limited by low or very low certainty in the evidence. 6