{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:21:31Z","timestamp":1788808891653,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric venous thromboembolism has increased by 130%\u2013200%, specifically in hospitalized children, and direct oral anticoagulants (DOACs) offer several therapeutic advantages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study aims to evaluate the real\u2010world epidemiological and outcome data from a retrospective review of pediatric patients treated with DOACs from January 1, 2013 to December 31, 2022. In this single\u2010center, IRB\u2010approved study, 65 patients were identified and analyzed using SPSS statistical software, and a descriptive statistical analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 65 patients, 37% were on apixaban, 61.5% were on rivaroxaban, and 1.5% were on dabigatran. Per the 2023 ISTH outcome definitions, one (2%) patient had a major bleeding episode, six (9%) had clinically relevant non\u2010major bleeding, three (5%) patients had patient\u2010important heavy menstrual bleeding (HMB), and one (1.5%) patient had minor bleeding. Seven (19%) of 37 postmenarchal patients had evidence of HMB. Six (9.2%) patients had recurrent venous thromboembolism while on a DOAC (one was on apixaban, and five were on rivaroxaban) and were transitioned to other forms of anticoagulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thus, bleeding rates after DOAC therapy are comparable to previous DOAC trials, as well as other anticoagulants in pediatrics. HMB is an important outcome measure and should continue to be investigated. This study reports a higher rate of recurrent thrombosis (9.2%) compared to other trials. However, this observation may be attributed to patients who had ongoing risk factors, as well as a longer duration of study follow\u2010up. Additional multicentered outcome studies evaluating DOAC use in children are needed to determine long\u2010term recurrence and HMB risks.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30926","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T09:38:56Z","timestamp":1709804336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Real\u2010world experience of direct oral anticoagulant use in a single pediatric center"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3950-8244","authenticated-orcid":false,"given":"Gianna G.","family":"Valenti","sequence":"first","affiliation":[{"name":"Department of Pediatrics Pediatric Hematology Oncology Children's Hospital of Michigan  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Sabo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Pediatric Hematology Oncology Children's Hospital of Michigan  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Hyde","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Pediatric Hematology Oncology Children's Hospital of Michigan  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhvi","family":"Rajpurkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Pediatric Hematology Oncology Children's Hospital of Michigan  Detroit Michigan USA"},{"name":"Central Michigan University School of Medicine  Mount Pleasant South Carolina USA"},{"name":"Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017013292"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000071"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021\u2010054649"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.10.029"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(20)30368\u20109"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(19)30219\u20104"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2022.100001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/PBC.29888"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2023.03.005"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14632"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2022.11.027"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018024786"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11\u20102308"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2021.23182"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1648949"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1647133"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1648377"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1649671"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1655964"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/BLOOD.V68.3.668.668"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/S005990050046"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/JTH.15047"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049\u20103848(75)90078\u2010X"},{"key":"e_1_2_8_25_1","volume-title":"Techniques for One\u2010Stage Factor VIII Assays","author":"Hillman CRH","year":"1989"},{"key":"e_1_2_8_26_1","unstructured":"Center for Disease Control.Thrombosis and hemostasis procedures. 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