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Heghine Khachatryan: Real-World Data on DOAC Use in Pediatric Oncology
Heghine Khachatryan/LinkedIn
Mar 13, 2026, 15:47

Heghine Khachatryan: Real-World Data on DOAC Use in Pediatric Oncology

Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared RPTH’s post on LinkedIn:

“New evidence continues to refine our understanding of anticoagulation in complex pediatric populations.

A recent publication in Research and Practice in Thrombosis and Haemostasis (RPTH) explores the safety and efficacy of direct oral anticoagulants (DOACs) in pediatric oncology patients, presenting real-world data from two tertiary pediatric centers.

Children with cancer represent a particularly vulnerable group, where thrombosis risk is increased due to malignancy, central venous catheters, and treatment-related factors.

Determining the optimal balance between thrombosis prevention and bleeding risk remains a critical clinical challenge.

Real-world data such as these are essential for guiding evidence-based decisions and improving outcomes in pediatric cancer-associated thrombosis.

Continued research will help clarify the role of DOACs in this delicate patient population.”

RPTH Journal shared a post on LinkedIn about a recent article by Riten Kumar et al, adding:

“Are DOACs truly safe for children with cancer-associated thrombosis?

Direct oral anticoagulants are transforming anticoagulation in adults.

But in pediatric oncology, the evidence base is still evolving.

A new real-world RPTH study examined 51 children with cancer receiving DOACs for treatment or prevention of VTE across two major pediatric centers.

Here’s the key signal:

  • Recurrent or progressive thrombosis occurred in 8% of patients
  • Major bleeding occurred in 6%, and clinically relevant nonmajor bleeding in 20%.

What’s important about these findings

  • Most patients received rivaroxaban or apixaban
  • Nearly half achieved complete thrombus resolution on follow-up imaging
  • Bleeding events were often linked to chemotherapy-related thrombocytopenia
  • Real-world complication rates were higher than some clinical trials

Translation:

DOACs are promising in pediatric oncology but real-world complexity matters.

Big questions moving forward:

  • What is the optimal anticoagulation intensity in children with cancer?
  • How should platelet thresholds guide anticoagulation decisions?
  • Can we better balance thrombosis prevention with bleeding risk during chemotherapy?”

Title: Safety and efficacy of direct oral anticoagulants in pediatric oncology patients: real-world data from two quaternary care pediatric centers

Authors: Riten Kumar, Emily Drake, Joseph Stanek, Nicholas Yeager, Lynda M. Vrooman, Lewis B. Silverman, Vilmarie Rodriguez

Read the Full Article on RPTH

Heghine Khachatryan

Other posts featuring Heghine Khachatryan on Hemostasis Today.

 

 

Direct Oral Anticoagulants DOACs Emily Drake Headlines Health Heghine Khachatryan Hematology Hemostasis Hemostasis News Hemostasis Today Joseph Stanek Lewis B. Silverman Lynda M. Vrooman Medicine Nicholas Yeager pediatric oncology Research and Practice in Thrombosis and Haemostasis Riten Kumar rpth thrombosis Vilmarie Rodriguez
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