Venous thromboembolism

Source: Late Effects of Treatment for Childhood Cancer (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: April 14, 2025 · Captured 2026-09-09.

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Context: Late Effects of the Cardiovascular System / Treatment Risk Factors / Radiation therapy

Children with cancer have an excess risk of venous thromboembolism within the first 5 years after diagnosis. However, the long-term risk of venous thromboembolism among childhood cancer survivors has not been well studied.[67]

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CCSS investigators evaluated self-reported late-onset (5 or more years after cancer diagnosis) venous thromboembolism among cohort members (median follow-up, 21.3 years).[68]

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The 35-year cumulative incidence of venous thromboembolism among survivors was 4.9%. This risk was twofold higher when compared with a sibling cohort (rate ratio, 2.2; 95% CI, 1.7–2.8).

Risk factors for venous thromboembolism among survivors included female sex, treatment with cisplatin or asparaginase, being affected by obesity or underweight, and recurrent primary or subsequent cancer.

The risk of late venous thromboembolism was higher among survivors of lower-extremity osteosarcoma treated with limb-sparing surgery compared with patients treated with amputation, possibly resulting from alterations in peripheral vascular anatomy and homeostasis.

Venous thromboembolism was associated with an almost-twofold increased risk of late mortality (RR, 1.9; 95% CI, 1.6–2.3).

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