{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T22:51:50Z","timestamp":1781823110579,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,3,28]],"date-time":"2016-03-28T00:00:00Z","timestamp":1459123200000},"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":["Br J Haematol"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Central Nervous System (<jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content>) thrombosis is a complication of acute lymphoblastic leukaemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>) treatment that is potentially associated with significant morbidity and neurological sequelae. Its presumably multifactorial aetiology is poorly characterized. We conducted a single\u2010centre, retrospective cohort study on 346 <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> paediatric patients (1\u201316\u00a0years old) treated with asparaginase intensive Dana Farber Cancer Institute (<jats:styled-content style=\"fixed-case\">DFCI<\/jats:styled-content>) protocols from 1998 to 2011. The incidence, risk factors and outcome of <jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content> thrombosis were evaluated. <jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content> thrombosis occurred in 3\u00b78% (13\/346) of the patients (95% confidence interval 2\u00b70\u20136\u00b73%). Twelve events were diagnosed during intensification, all of which resolved within 2\u00a0weeks without neurological sequelae or significant impact in survival. Obesity (body mass index above 95th percentile) and asparaginase formulation were the only factors associated with <jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content> thrombosis, with an increase in the odds of event in obese patients [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>)\u00a0=\u00a03\u00b737; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7064] and a reduction in patients receiving Erwinia asparaginase (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00\u00b712; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7018). No association could be demonstrated for age, gender, <jats:styled-content style=\"fixed-case\">DFCI<\/jats:styled-content> risk\u2010group, <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> phenotype, steroid or doxorubicin use, central venous line use or <jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content> radiotherapy. <jats:styled-content style=\"fixed-case\">CNS<\/jats:styled-content> thrombosis is a rare but manageable adverse event without significant sequelae or detrimental effects in survival. Increased awareness is recommended in obese patients particularly during intensive asparaginase use.<\/jats:p>","DOI":"10.1111\/bjh.14048","type":"journal-article","created":{"date-parts":[[2016,3,28]],"date-time":"2016-03-28T05:13:16Z","timestamp":1459141996000},"page":"280-291","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Incidence and risk factors for Central Nervous System thrombosis in paediatric acute lymphoblastic leukaemia during intensive asparaginase treatment: a single\u2010centre cohort study"],"prefix":"10.1111","volume":"174","author":[{"given":"Ximo","family":"Duarte","sequence":"first","affiliation":[{"name":"Paediatric Department Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Esteves","sequence":"additional","affiliation":[{"name":"Clinical Research Unit Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Neto","sequence":"additional","affiliation":[{"name":"Paediatric Department Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Pereira","sequence":"additional","affiliation":[{"name":"Paediatric Department Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V83.5.1251.1251"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mbc.0000214709.11492.ec"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2003.10.007"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05528.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2329C"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-04-015511"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.10.006"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.8.2734"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08524.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000087598.05977.45"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/865979"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200306000-00011"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V83.2.386.386"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11042"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2013.04.009"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(01)00286-9"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1182\/blood.V93.5.1595","article-title":"Prospective evaluation of the thrombotic risk in children with acute lymphoblastic leukemia carrying the MTHFR TT 677 genotype, the prothrombin G20210A variant, and further prothrombotic risk factors","volume":"93","author":"Nowak\u2010G\u00f6ttl U.","year":"1999","journal-title":"Blood"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1538-7836.2003.00465.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073812446160"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08132.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13162"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31827e8dbd"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401980"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.5.1211"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.253"},{"key":"e_1_2_6_27_1","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Swerdlow S.H.","year":"2008"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23355"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.2070"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbjh.14048","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.14048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T04:52:06Z","timestamp":1696308726000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.14048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,28]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1111\/bjh.14048"],"URL":"https:\/\/doi.org\/10.1111\/bjh.14048","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,28]]},"assertion":[{"value":"2015-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}