Browse by author
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).
© 2026 American Society of Hematology. Background: Venous thromboembolism (VTE) is a significant cause of morbidity in children, particularly among hospitalized patients and those with chronic medical conditions. There is a lack of consensus on anticoagulant prophylaxis strategies. Objective: These evidence-based guidelines from the American Society of Hematology (ASH) and the International Society on Thrombosis and Haemostasis (ISTH) are intended to support patients and health care professionals in decisions about anticoagulant prophylaxis for pediatric VTE prevention. Methods: ASH formed a multidisciplinary guideline panel that included 1 patient representative. The University of Kansas Health System supported the guideline development process, including systematic evidence reviews up to April 2025. Clinical questions and outcomes were prioritized according to their importance for clinicians and patients. The panel used the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to assess certainty in the evidence and make recommendations. Results: The panel agreed on 12 recommendations. For pediatric patients with solid cancer, who have experienced trauma, or who are critically ill, the panel issued conditional recommendations suggesting no anticoagulant prophylaxis. For pediatric patients with antiphospholipid antibody syndrome, or those on long-term total parenteral nutrition, the panel issued conditional recommendations suggesting the use of anticoagulant prophylaxis. Other pediatric subgroups addressed included patients with acute lymphoblastic leukemia or lymphoma, surgical and hospitalized patients, and those with a central venous access device. Conclusions: High-quality data on anticoagulant prophylaxis for pediatric VTE prevention are scarce. Key research priorities include the development and validation of subgroups-specific VTE risk assessment models, and evaluation of the safety and efficacy of risk-stratified anticoagulant prophylaxis strategies across different pediatric subgroups.
Author(s): Betensky M, Azzam M, Bercovitz R, Bhat RV, Biss T, Branchford B, Brandao LR, Chan AKC, Vincent S Faustino E, Hamarsha Q, Jaffray J, Jones S, Kawtharany H, Kerlin BA, Khawandi J, Krider G, Kucine N, Kumar R, Male C, Monagle P, Pelland-Marcotte M-C, Raffini L, Raulji C, Sartain SE, Takemoto CM, Tarango C, Heleen van Ommen C, Velez MC, Vesely SK, Wiernikowski J, Williams S, Wilson HP, Woods G, Mustafa RA
Publication type: Article
Publication status: Published
Journal: Blood Advances
Year: 2026
Volume: 10
Issue: 12
Pages: 4303-4333
Print publication date: 12/06/2026
Online publication date: 08/04/2026
Acceptance date: 18/06/2026
Date deposited: 01/07/2026
ISSN (print): 2473-9529
ISSN (electronic): 2473-9537
Publisher: American Society of Hematology
URL: https://doi.org/10.1182/bloodadvances.2025019415
DOI: 10.1182/bloodadvances.2025019415
PubMed id: 41949461
Altmetrics provided by Altmetric
