Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Emicizumab prophylaxis vs immune tolerance induction in children with severe hemophilia A and inhibitors: a retrospective comparison of bleeding control, quality of life, and cost.","authors":"Zhengping Li, Qianqian Mao, Gang Li, Xiaoling Cheng, Yingzi Zhen, Guoqing Liu, Wanru Yao, Zekun Li, Jialu Zhang, Shuyue Dong, Di Ai, Zhenping Chen, Runhui Wu","doi":"10.1016/j.rpth.2026.103425","DOIUrl":"https://doi.org/10.1016/j.rpth.2026.103425","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence directly comparing emicizumab (EMI) prophylaxis and immune tolerance induction (ITI) in children with severe hemophilia A and high-titer inhibitors (SHAcwHTI), particularly bleeding control, quality of life (QoL), and cost.</p><p><strong>Objectives: </strong>This study compared outcomes of EMI vs ITI in SHAcwHTI, focusing on bleeding rates, QoL, and costs.</p><p><strong>Methods: </strong>This single-center retrospective study enrolled SHA children (inhibitor titer ≥5 Bethesda Units/mL), receiving EMI or ITI from January 2020 to December 2024. EMI included loading (initial 4 weeks) and maintenance doses; ITI involved intermediate-dose (factor [F]VIII 100 IU/kg/d) or low-dose (FVIII 50 IU/kg once every other day). Outcomes included annualized bleeding rate (ABR), annualized joint bleeding rate (AJBR), Canadian Hemophilia Outcomes-Kids Life Assessment Tool scores, and medication costs.</p><p><strong>Results: </strong>Among 140 patients (24 in EMI group and 116 in ITI group [40 intermediate-dose ITI and 76 low-dose ITI]), EMI was associated with better bleeding control: median ABR and AJBR were 0 across all observation periods, significantly lower than ITI. For ITI, both ABR and AJBR declined over time but remained higher than those of EMI group. Target joint proportion decreased most markedly in patients receiving EMI (35.7%-0%; <i>P</i> = 0.002). EMI group also showed greater QoL improvement (mean change in parent proxy-reported Canadian Hemophilia Outcomes-Kids Life Assessment Tool scores: +26.6 vs +19.2 vs +19.1; <i>P</i> < .001) and lower medication costs (1993.4 vs 3703.4 vs 3656.3 US$/kg; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>EMI prophylaxis was associated with improved bleeding control and QoL while reduced costs compared with ITI, offering a valuable option for SHAcwHTI, prioritizing immediate hemostasis over the long-term goal of inhibitor eradication, especially in resource-limited settings.</p>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"103425"},"PeriodicalIF":3.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician perspectives on antithrombotic therapy management in advanced cancer: a multinational qualitative study","authors":"Elin Baddeley ,&nbsp;Carme Font ,&nbsp;Isabelle Mahé ,&nbsp;Michelle Edwards ,&nbsp;Stephanie Sivell ,&nbsp;Kate J. Lifford ,&nbsp;Victoria Mailen Arfuch ,&nbsp;Nuri Coma-Auli ,&nbsp;Mette Søgaard ,&nbsp;Helle Enggaard ,&nbsp;Hélène Helfer ,&nbsp;Nassima Si Mohammed ,&nbsp;Kathy Seddon ,&nbsp;Simon P. Mooijaart ,&nbsp;Mark Pearson ,&nbsp;Sebastian Szmit ,&nbsp;F.A. Klok ,&nbsp;Simon Noble ,&nbsp;Anette Arbjerg Højen ,&nbsp;SERENITY consortium","doi":"10.1016/j.rpth.2026.103427","DOIUrl":"10.1016/j.rpth.2026.103427","url":null,"abstract":"<div><h3>Background</h3><div>Decision making about antithrombotic therapy (ATT) in patients with advanced cancer near the end of life is fraught with clinical uncertainty and can significantly affect care. Despite its importance and complexity, ATT is often deprioritized or guided by legacy prescribing and monitoring patterns. Management spans multiple specialties, with roles and responsibilities frequently blurred. Clinicians’ perspectives remain largely underexplored, which are crucial to inform improved care models.</div></div><div><h3>Objectives</h3><div>This study explores clinicians’ experiences of current practice of continuing and deprescribing ATT in patients with advanced cancer at the end of life.</div></div><div><h3>Methods</h3><div>Qualitative methodology using semistructured interviews with clinicians involved in ATT management at the end of life, across Denmark, France, Spain, and the United Kingdom. Data were analyzed using Framework Analysis.</div></div><div><h3>Results</h3><div>Eighty clinicians across a range of specialties were interviewed. Two major themes were generated: (1) balancing complexities in ATT management: clinicians reported several challenges, from ambiguity surrounding roles and responsibilities, delicacy around timing, and variance in risk perceptions of ATT, balanced with patient preferences; and (2) culture of continuation: clinicians described a general and ATT-specific culture of continuation and reported a passivity in relation to ATT review.</div></div><div><h3>Conclusion</h3><div>The management of ATT in this context is multifaceted, influenced by many competing factors. These complexities need to be understood and addressed to support decision making related to ATT at the end of life.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103427"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of presentation of suspected and confirmed recurrent venous thromboembolism in patients with prior venous thromboembolism","authors":"Vicky Mai ,&nbsp;Emily S.L. Martens ,&nbsp;Marc Righini ,&nbsp;Sam Schulman ,&nbsp;Venkatesh Thiruganasambandamoorthy ,&nbsp;Veronica Bates ,&nbsp;Amanda Pecarskie ,&nbsp;Michael J. Kovacs ,&nbsp;Shaun Visser ,&nbsp;Sudeep Shivakumar ,&nbsp;Melanie Tan ,&nbsp;Marc Rodger ,&nbsp;Dimitrios Scarvelis ,&nbsp;Aurélien Delluc ,&nbsp;Philippe Girard ,&nbsp;Menno V. Huisman ,&nbsp;Philip S. Wells ,&nbsp;Frederikus A. Klok ,&nbsp;Grégoire Le Gal ,&nbsp;Susan R. Kahn ,&nbsp;Clive Kearon","doi":"10.1016/j.rpth.2026.103442","DOIUrl":"10.1016/j.rpth.2026.103442","url":null,"abstract":"<div><h3>Background</h3><div>Patients with prior venous thromboembolism (VTE) seem to recur more frequently at the same site as their prior VTE, but their symptoms at presentation of suspected recurrent VTE is unclear.</div></div><div><h3>Objectives</h3><div>The aim was to describe the patterns of presentation of suspected and confirmed recurrent VTE.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of the PREDICTORS study (ClinicalTrials.gov: <span><span>NCT02297373</span><svg><path></path></svg></span>), an international prospective multicenter observational cohort study. The primary outcomes were the location of symptoms and confirmed diagnosis of suspected recurrent VTE.</div></div><div><h3>Results</h3><div>In total, 708 patients were included. Patients with isolated deep venous thrombosis (DVT) as the most recent prior VTE presenting with suspected recurrent VTE had more frequently lower extremity symptoms only (249/343; 73%), rather than respiratory symptoms only (41/343; 12%), and confirmed recurrent VTE were mostly isolated proximal DVT (78/100; 78%). Patients with isolated pulmonary embolism as the most recent prior VTE presented more frequently with respiratory symptoms only (136/237; 56%), rather than lower extremity symptoms only (42/237; 18%), and confirmed recurrent VTE were more frequently isolated pulmonary embolism (38/62; 61%). Among patients with DVT as the most recent prior VTE, confirmed recurrent DVT were more frequently in the ipsilateral leg of the index event (ipsilateral 72/468 [15%], contralateral 31/468 [7%]; odds ratio 2.3 [95% CI, 1.5-3.6]).</div></div><div><h3>Conclusion</h3><div>In addition to confirming that patients were more frequently diagnosed with recurrent VTE at the same site of their last VTE, our study reported on suspected recurrent VTE symptoms and showed that patients presented more frequently with symptoms related to the same site of their last VTE.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103442"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147750611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing patterns and clinician preferences for direct oral anticoagulant use in unusual site venous thromboembolism: a cross-sectional analysis from the Direct oral anticoagulants in Unusual Site venous Thromboembolism (DUST) study","authors":"Nicoletta Riva ,&nbsp;Laurent Bertoletti ,&nbsp;Antonio Chistolini ,&nbsp;Valerio De Stefano ,&nbsp;Sofia Barbar ,&nbsp;Marco Paolo Donadini ,&nbsp;Maria Teresa Sartori ,&nbsp;Francis Couturaud ,&nbsp;Michelangelo Sartori ,&nbsp;Alexander Gatt ,&nbsp;Omri Cohen ,&nbsp;Chiara Fantoni ,&nbsp;Scott Kaatz ,&nbsp;Alenka Mavri ,&nbsp;Isabelle Mahé ,&nbsp;Judith Catella ,&nbsp;Pedro Ruiz-Artacho ,&nbsp;Giorgio Ghigliotti ,&nbsp;Luis Jara-Palomares ,&nbsp;Gian Marco Podda ,&nbsp;Walter Ageno","doi":"10.1016/j.rpth.2026.103462","DOIUrl":"10.1016/j.rpth.2026.103462","url":null,"abstract":"<div><h3>Background</h3><div>Unusual site venous thromboembolism (USVTE) presents therapeutic challenges. Direct oral anticoagulants (DOACs) are increasingly prescribed despite limited evidence from clinical trials.</div></div><div><h3>Objectives</h3><div>This cross-sectional analysis aimed to describe DOAC prescription patterns and rationale for choosing DOACs for USVTE treatment in real-life clinical practice.</div></div><div><h3>Methods</h3><div>The Direct oral anticoagulants in Unusual Site venous Thromboembolism study (NCT03778502) is an international, multicenter, prospective, observational registry. Adult patients with objectively diagnosed USVTE (years 2018-2023) treated with DOACs were included. Information was collected on patient characteristics, USVTE location, anticoagulant treatment, and rationale for starting DOACs.</div></div><div><h3>Results</h3><div>In total, 349 patients were included from 23 centers in 9 countries. The most common USVTE were splanchnic vein thrombosis (<em>n</em> = 219, 62.8%) and cerebral vein thrombosis (<em>n</em> = 103, 29.5%). The most prescribed DOACs were apixaban (<em>n</em> = 186, 53.3%) and rivaroxaban (<em>n</em> = 101, 28.9%). The median delay between USVTE diagnosis and DOAC initiation was 24 days, with 219 patients (62.8%) starting DOACs &gt;14 days after diagnosis. Indeed, 320 (91.7%) patients received other anticoagulants before switching to DOACs (mainly low-molecular-weight heparin, <em>n</em> = 217, 67.8%). The main reasons for prescribing DOACs were oral administration (145/336, 43.2%), no need for blood monitoring (131/336, 39.0%), favorable safety profile (116/336, 34.5%), and prescriber-reported patient’s preference (96/336, 28.6%). Apixaban was the most prescribed DOAC in splanchnic vein thrombosis (133/219, 60.7%), while dabigatran was the most prescribed DOAC in cerebral vein thrombosis (38/103, 36.9%).</div></div><div><h3>Conclusion</h3><div>DOACs are increasingly prescribed for USVTE owing to their ease of use and perceived safety, but mainly after initial treatment with parenteral anticoagulation. Further evidence is still needed to support their use in the acute phase.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103462"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147750614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic landscape of inherited bleeding disorders in China","authors":"Yun Wang ,&nbsp;Feng Xue ,&nbsp;Man-Chiu Poon ,&nbsp;Renchi Yang","doi":"10.1016/j.rpth.2026.103460","DOIUrl":"10.1016/j.rpth.2026.103460","url":null,"abstract":"<div><div>The demand for diagnosis and treatment of inherited bleeding disorders, particularly hemophilia, is increasing in China. In recent years, significant progress has been made in the country regarding the development and application of related therapeutics and the construction of the Chinese healthcare delivery system with attention to more efficient, cost-effective and convenient healthcare access to the population in both the remote/rural and urban areas. This article aims to systematically review the current therapeutic landscape of inherited bleeding disorders in China, elucidate the developmental pipeline of investigational domestic novel drugs, and discuss the establishment of a tiered healthcare system for hemophilia in China in line with the developing national healthcare delivery system. Attention to research and development in China have resulted in increased therapeutic product manufacturing capacity, and China is progressively establishing a domestic supply system for therapeutics ranging from basic replacement therapies to advanced treatments including gene therapy for inherited bleeding disorders. Concurrently, the ongoing development of the tiered healthcare system is expected to optimize the allocation of medical resources and enhance the standardization of diagnosis and treatment nationwide. In the future, the successful development of domestic innovative drugs, combined with an efficient and cost-effective healthcare delivery system, will lay a solid foundation for improving treatment outcomes and the quality of life for patients in China.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103460"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance to age-related hypercoagulability: insights from the naked mole rat","authors":"Véronique Regnault ,&nbsp;Jeremy Lagrange ,&nbsp;Chris G. Faulkes ,&nbsp;J. Kennedy Cruickshank ,&nbsp;Cécile Lakomy ,&nbsp;Athanase Benetos ,&nbsp;Cécile V. Denis ,&nbsp;Patrick Lacolley","doi":"10.1016/j.rpth.2026.103458","DOIUrl":"10.1016/j.rpth.2026.103458","url":null,"abstract":"<div><h3>Background</h3><div>Human aging is characterized by endothelial dysfunction that drives a systemic prothrombotic shift. In contrast, the long-lived naked mole rat (NMR) represents a unique model of delayed aging, exhibiting a notable resistance to age-related pathologies. However, while its cardiovascular stability is well-documented, the NMR hemostatic profile across its lifespan remains unexplored.</div></div><div><h3>Objectives</h3><div>To assess whether NMRs undergo age-related hypercoagulability and to compare their hemostatic trajectory with that of humans.</div></div><div><h3>Methods</h3><div>We compared young (2-year-old) and aged (20-year-old) NMRs. Assessments included clotting factor quantification, endothelial markers, and integrative thrombin generation assays. Plasma from human volunteers (20-year-old vs 80-year-old NMRs) were used as a reference point for typical hemostatic aging.</div></div><div><h3>Results</h3><div>NMRs maintained cellular blood composition and showed no age-related increase in markers of endothelial activation (including von Willebrand factor, factor VIII, tissue factor pathway inhibitor, soluble thrombomodulin, and tissue plasminogen activator). While aged NMRs showed a modest increase in fibrinogen and D-dimer, this rise was significantly lower than the 2- to 5-fold elevations seen in elderly humans. Most notably, thrombin generation potential remained identical between young and aged NMRs. In contrast, humans exhibited a marked age-dependent shift toward accelerated and heightened thrombin production.</div></div><div><h3>Conclusion</h3><div>NMRs possess the ability to bypass the pathologic clotting shifts that drive thrombotic events in humans, effectively decoupling chronologic aging from prothrombotic risk. By maintaining stable endothelial coagulation markers and an unchanged thrombin-forming capacity throughout their lifespan, NMRs appear naturally protected against age-dependent hypercoagulability.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103458"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care resource utilization and costs of major bleeding in patients with and without dialysis-dependent end-stage kidney disease: a retrospective study","authors":"Nicholas S. Roetker ,&nbsp;Alejandro Victores ,&nbsp;Chuanyu Kou ,&nbsp;Lori D. Bash ,&nbsp;Dena Rosen Ramey ,&nbsp;Xuehua Ke ,&nbsp;Marc P. Bonaca ,&nbsp;James B. Wetmore","doi":"10.1016/j.rpth.2026.103437","DOIUrl":"10.1016/j.rpth.2026.103437","url":null,"abstract":"<div><h3>Background</h3><div>Major bleeding is common in dialysis-dependent end-stage kidney disease (ESKD).</div></div><div><h3>Objectives</h3><div>To compare healthcare resource utilization (HCRU) and costs of major bleeding events between dialysis and non-dialysis populations.</div></div><div><h3>Methods</h3><div>We identified fee-for-service Medicare beneficiaries aged ≥66 years with a first (index) major bleeding event in 2015-2018. Patients with ESKD receiving in-center hemodialysis (HD) and home dialysis from the US Renal Data System were each compared to patients without ESKD from a 20% Medicare sample. HCRU and cost outcomes were compared using model-based standardization, adjusted for age, sex, and race, during the index major bleeding event and a 1-year follow-up period.</div></div><div><h3>Results</h3><div>Patients receiving in-center HD had index major bleeding hospitalizations that were longer and costlier (adjusted mean differences: 0.7 days [95% CI, 0.6-0.8] and $3.4K [95% CI, $3.2K-$3.7K]) than those without ESKD. During 1-year follow-up, bleeding-related hospitalizations were more common (adjusted rate difference: 37.6 per 100 person-years [95% CI, 35.2-40.1]) and costly (adjusted per-person per-year cost difference: $6.2K [95% CI, $5.8K-$6.7K]) in patients receiving in-center HD than in those without ESKD. Other than blood transfusions, which were more common in home dialysis than in-center HD (adjusted rates per 100 person-years: 255.8 [95% CI, 241.8-269.8] vs 202.1 [95% CI, 199.2-205.0]), HCRU outcomes were generally similar between the dialysis groups.</div></div><div><h3>Conclusion</h3><div>Patients receiving dialysis had longer and costlier major bleeding hospitalizations and accrued substantially higher costs after 1 year versus those without ESKD. Readmissions were a key driver of higher HCRU and costs in ESKD.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103437"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cathepsin G is associated with cerebral vascular injury in myeloid leukemia: a pathologic insight into intracranial hemorrhage","authors":"Toshihiro Gi ,&nbsp;Kaiyou Kai ,&nbsp;Kotaro Shide ,&nbsp;Eriko Nakamura ,&nbsp;Nobuyuki Oguri ,&nbsp;Murasaki Aman ,&nbsp;Kazunari Maekawa ,&nbsp;Sayaka Moriguchi-Goto ,&nbsp;Michikazu Nakai ,&nbsp;Kazuya Shimoda ,&nbsp;Yohei Hisada ,&nbsp;Atsushi Yamashita","doi":"10.1016/j.rpth.2026.103433","DOIUrl":"10.1016/j.rpth.2026.103433","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial hemorrhage (ICH) is a fatal complication of leukemia; however, mechanisms underlying its development, particularly central nervous system (CNS) involvement and vascular injury, remain unclear.</div></div><div><h3>Objectives</h3><div>We aimed to investigate the histopathologic features of cerebral vessels in leukemia and the expression of hemostasis-related factors in leukemia cells.</div></div><div><h3>Methods</h3><div>We conducted an autopsy-based study including 37 leukemia cases and 20 matched controls. Histopathologic analysis of CNS tissues was performed to evaluate ICH, leukemia cell localization, and vascular injury. Immunohistochemistry was performed to assess expression of vascular endothelial growth factor (VEGF), cathepsin G, tissue-type plasminogen activator, urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor, and tissue factor in leukemia cells. Vascular integrity was evaluated using stains for smooth muscle actin, collagen, fibrin, and von Willebrand factor.</div></div><div><h3>Results</h3><div>ICH was identified in 68% of leukemia cases and was associated with fatal brain herniation in 40%. CNS involvement was observed in 54% of cases, often without a clinical diagnosis. The leukemia cell infiltration of meninges and vascular walls was frequently associated with changes in smooth muscle cells and adventitial collagen. CNS vascular injury was frequently associated with ICH in the presence of leukemia cell infiltration. VEGF and urokinase-type plasminogen activator were highly expressed in leukemia cells. VEGF was associated with meningeal invasion, while cathepsin G was predominantly expressed in myeloid leukemia and linked to vascular damage.</div></div><div><h3>Conclusion</h3><div>VEGF and cathepsin G may serve as markers of meningeal invasion and cerebral vascular damage in leukemia, respectively.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103433"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early venous thrombus resolution in neonates/infants: retrospective review of a 20-year single institution experience","authors":"Elizabeth Yan ,&nbsp;Mary Bauman ,&nbsp;Leanne Meakins ,&nbsp;Aisha Bruce ,&nbsp;Joel Livingston","doi":"10.1016/j.rpth.2026.103455","DOIUrl":"10.1016/j.rpth.2026.103455","url":null,"abstract":"<div><h3>Background</h3><div>Due to differences in developmental hemostasis, the management of neonatal and infant venous thromboembolism requires special consideration compared with adults and even older children. The benefits of anticoagulation to optimize thrombus resolution and prevent recurrence need to be balanced with the risks of bleeding, and recent studies support shorter courses of anticoagulation treatment for children.</div></div><div><h3>Objectives</h3><div>Review outcomes of neonatal (age ≤28 days) and young infant (age ≤3 months) thrombi treated at a single institution over a 20-year period with the standard practice of performing an ultrasound at 2 to 4 weeks postdiagnosis and discontinuing anticoagulation with thrombus resolution.</div></div><div><h3>Methods</h3><div>All deep vein thrombosis (DVT) diagnosed in patients ≤3 months of age between October 2003 and January 2025 were reviewed retrospectively, with arterial, superficial vein, portal vein, and/or renal vein thrombi excluded.</div></div><div><h3>Results</h3><div>A total of 151 patients met criteria (neonates = 79 and young infants = 72), and 179 DVTs were identified. The median resolution time was 28 (IQR, 13-60) days, with a significant proportion of thrombi resolving by 2 (16.8%) and 4 (28.5%) weeks, respectively. DVTs that were more likely to resolve early included those affecting the upper limb and those that were initially partially occlusive. No significant differences in venous thromboembolism resolution were observed between cardiac versus noncardiac patients. Post-DVT treatment, the 1-year recurrence rate was low at 3.4%.</div></div><div><h3>Conclusion</h3><div>These findings suggest a significant proportion of DVT in children aged ≤3 months of age may resolve within 2 to 4 weeks postdiagnosis, and ultrasound screening in this timeframe may be useful in limiting anticoagulation duration to reduce potential bleeding risks.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103455"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The in vitro anticoagulant effect of abelacimab in healthy children","authors":"Natasha Letunica ,&nbsp;Simon Collett ,&nbsp;Vasiliki Karlaftis ,&nbsp;Yasser Khder ,&nbsp;Debra Freedholm ,&nbsp;Paul Monagle ,&nbsp;Chantal Attard","doi":"10.1016/j.rpth.2026.103446","DOIUrl":"10.1016/j.rpth.2026.103446","url":null,"abstract":"<div><h3>Background</h3><div>Safe and effective anticoagulants are crucial for managing thrombotic disorders, particularly in children. Although direct oral anticoagulants offer advantages, including predictable pharmacokinetics and minimal monitoring, their bleeding risks remain similar to traditional anticoagulants. Abelacimab, a novel, dual-acting monoclonal antibody targeting factor XI (FXI)/activated FXI, shows promise in providing the potential for antithrombotic efficacy while reducing bleeding risks in adults and warrants further investigation in children.</div></div><div><h3>Objectives</h3><div>To investigate the <em>in vitro</em> age-related anticoagulant effect of abelacimab in healthy individuals from children to adults, before <em>in vivo</em> testing.</div></div><div><h3>Methods</h3><div>Citrated plasma samples from 60 healthy participants across 6 age groups (1-6 months, 6 months to 2 years, 2-6 years, 6-12 years, 12-18 years, and adults) were spiked with increasing concentrations of abelacimab (0, 0.3, 1.0, 3.0, 10, 30, and 100 μg/mL). Activated partial thromboplastin time and FXI coagulation activity were measured using commercially available reagents.</div></div><div><h3>Results</h3><div>A sigmoidal, concentration-dependent increase in clotting time was observed across all age groups, with the 1- to 6-month age group exhibiting significantly prolonged clotting times compared with adults at most concentrations. FXI coagulation activity was comparable among all pediatric age groups and adults, with the exception of the 1- to 6-month age group.</div></div><div><h3>Conclusion</h3><div><em>In vitro</em> findings indicate a predictable concentration-response to abelacimab, with significant pharmacodynamics differences in young children. <em>In vivo</em> studies are required to confirm these findings, optimize dosing, and assess clinical implications in the pediatric population.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 3","pages":"Article 103446"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147712449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}