RESUMO
This is the first study examining real-life data of pediatric cancer patients treated with rivaroxaban. Children with thrombocytopenia and high bleeding risk were excluded from previous clinical trials. Data regarding the safety and efficacy of rivaroxaban in pediatric cancer-associated thrombosis are scarce. Our case series included 16 children aged 7.5-17 years. Thrombus resolution rate in our study was comparable to results of previous studies. However, higher rates of thrombotic and bleeding complications were seen in our study as compared to previous reports, especially among patients with relapsed or refractory disease.
Assuntos
Neoplasias , Trombose , Tromboembolia Venosa , Anticoagulantes/uso terapêutico , Criança , Inibidores do Fator Xa/efeitos adversos , Hemorragia/induzido quimicamente , Hemorragia/complicações , Humanos , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Rivaroxabana/efeitos adversos , Trombose/tratamento farmacológico , Resultado do Tratamento , Tromboembolia Venosa/etiologiaRESUMO
Little is known about the challenging treatment of pediatric patients with hemophilia B and inhibitors due to disease rarity. We describe three patients diagnosed in childhood and followed up to 9 years. All three had allergic reactions to Factor IX, but two were later safely treated for bleeding episodes with activated prothrombin complex concentrates (APCC = FEIBA). The third was given only recombinant activated Factor VIIa. Based on ex vivo thrombin generation analysis, a new alternative treatment of combined bypassing agents was administered for bleeding episodes and several minor surgical procedures with no treatment-associated adverse events or thrombosis.
Assuntos
Fatores de Coagulação Sanguínea/uso terapêutico , Fator VIIa/uso terapêutico , Hemofilia B/tratamento farmacológico , Trombina/biossíntese , Adolescente , Testes de Coagulação Sanguínea/métodos , Pré-Escolar , Humanos , Masculino , Proteínas Recombinantes/uso terapêutico , Trombina/efeitos dos fármacosRESUMO
A 6 months old infant, diagnosed with a rare mutation causing severe hemophilia A, presented with spinal epidural hematoma. Parents later admitted the infant had glass cupping therapy performed within 2 weeks of the onset of symptoms. The rare mutation, rare bleeding complication, and the eventual course of therapy applied in this case will be discussed in our case report.