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Lookup NU author(s): Dr Tina Biss
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025 American Society of Hematology. All other rights reserved. Background: The American Society of Hematology (ASH) guidelines on treatment of pediatric venous thromboembolism (VTE) were published in 2018. In the last 6 years, there has been a 10-fold increase in the number of children involved in VTE treatment trials. Objective: The ASH Committee on Quality and Guidelines agreed to update the pediatric guidelines in conjunction with the International Society on Thrombosis and Haemostasis (ISTH). These ASH/ISTH evidence-based guidelines are intended to support patients, clinicians, and other health care professionals in the management of pediatric patients with VTE. Methods: ASH/ISTH formed a multidisciplinary guideline panel to minimize potential bias from conflicts of interest. An unconflicted patient representative was not identified. The University of Kansas Health System supported the guideline development process, updating or performing systematic evidence reviews up to 2024. The panel focused specifically on the 2018 questions for which there was the greatest amount of interim data. The panel used the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 20 recommendations and also provided implementation guidance on the optimal use of anticoagulants in pediatric patients. Key recommendations of these guidelines include the role of DOACs in the treatment of a variety of pediatric VTEs. Conclusions: Further research is required. Key priorities are understanding the natural history of clinically unsuspected thrombosis across a range of patient subpopulations and obtaining real-world data on the use of DOACs in children.
Author(s): Monagle P, Azzam M, Bercovitz R, Betensky M, Bhat R, Biss T, Branchford B, Brandao LR, Chan AKC, Faustino VES, Jaffray J, Jones S, Kawtharany H, Kerlin BA, Kucine N, Kumar R, Male C, Pelland-Marcotte M-C, Raffini L, Raulji C, Sartain SE, Takemoto CM, Tarango C, van Ommen CH, Velez MC, Vesely SK, Wiernikowski J, Williams S, Wilson HP, Woods G, Zia A, Mustafa RA
Publication type: Article
Publication status: Published
Journal: Blood Advances
Year: 2025
Volume: 9
Issue: 10
Pages: 2587-2636
Print publication date: 27/05/2025
Online publication date: 27/05/2025
Acceptance date: 14/01/2025
Date deposited: 26/06/2025
ISSN (print): 2473-9529
ISSN (electronic): 2473-9537
Publisher: American Society of Hematology
URL: https://doi.org/10.1182/bloodadvances.2024015328
DOI: 10.1182/bloodadvances.2024015328
PubMed id: 40423983
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