Marie-Claude Pelland-Marcotte

• Pediatric Hematologist/Oncologist at Université Laval

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 guideli...

Dosing guidance for anticoagulation, the mainstay of venous thromboembolism (VTE) treatment, is lacking for obese children. We aimed to compare unfractionated heparin (UFH) and low-molecular-weight heparins (LMWH) dosing requirements and clinical outcomes between obese/overweight and nonobese children. This monocentric retrospective cohort study in...

Background Childhood obesity can result in adverse health outcomes. The objectives of this study were to describe the prevalence of obesity and determine the association between obesity at cancer diagnosis and event‐free survival (EFS) and overall survival (OS) in children diagnosed with cancer in Canada. Methods The authors conducted a retrospect...

Background Intravenous immunoglobulin (IVIG) therapy is used in the treatment of pediatric diseases, although data about IVIG‐related adverse events (IVIG‐AEs) are limited. Objectives of this study were to document the incidence of IVIG‐AEs in pediatric hospitalized patients and to identify risk factors for IVIG‐AEs. Methods This retrospective coh...

Introduction: VTE in pediatric patients is usually managed with anticoagulation (AC), however, thrombolytic therapy may be necessary to rapidly restore venous patency in cases of life- or limb-threatening VTEs. The available evidence on the benefits and outcomes of thrombolysis in pediatric VTE is limited. We performed a systematic review and meta-...

Introduction: Venous thromboembolism (VTE) in the pediatric population is a heterogenous disease due to the variability in age, anatomical location, and comorbidities. Anticoagulation (AC) is considered the main treatment option; however, the decision to anticoagulate necessitates consideration of benefits and risk based on multiple factors. We per...

Background:Venous thromboembolism (VTE) and obesity are both dramatically increasing among all pediatric age groups. Dosing guidance for anticoagulation in children with obesity remains uncertain even though nearly 20% of Canadian children are deemed obese, despite possible pharmacokinetics differences. Aims:Between obese and non-obese children rec...

Introduction: Neonates are particularly at risk of thromboembolism (TE), especially neonates requiring central lines. Management of neonatal TE is particularly complex, as the higher risk of bleeding must be balanced with the thrombotic risks, including organ dysfunction, post-thrombotic syndrome and death. The objectives of this study are to descr...

Background: Up to 50% of children with cancer may develop clinically unsuspected venous thrombo-embolisms (VTE), most related to an underlying central venous catheter (CVC). Whether clinically unsuspected and symptomatic VTEs are associated with similar long-term clinical impacts in children with cancer is controversial. Aims:To describe the propor...

Background The objective of this study is to assess the concordance and added value of combined comparative genomic hybridization plus single‐nucleotide polymorphism microarray (CGH/SNP) analyses in pediatric acute lymphoblastic leukemia (ALL) risk stratification compared to conventional cytogenetic methods. Procedure This is a retrospective study...

Introduction From the advancement of treatment of pediatric cancer diagnosis, the five-year survival rate has increased significantly. However, the adverse consequence of improved survival rate is the second malignant neoplasm. Although previous studies provided information on the incidence and risk of SMN in long term survivors of childhood cancer...

Children with SARS-CoV-2 infection have been consistently described with milder clinical outcomes compared to adults. However, data pertaining to the clinical evolution of SARS-CoV-2 infection in children with cancer remain scarce. In this descriptive cohort study, we report the clinical characteristics and outcomes of 31 pediatric oncology patient...

Congenital erythropoietic porphyria (CEP) is caused by a defect in the heme biosynthesis pathway of the enzyme uroporphyrinogen III synthase (UROS) leading to an accumulation of non-physiological porphyrins. The exposure of accumulated porphyrins to sunlight causes severe photosensitivity, chronic intravascular hemolysis and, eventually, irreversib...

Thromboembolism (TE) is associated with reduced survival in pediatric acute lymphoblastic leukemia (ALL). It has been hypothesized that TE might signal leukemic aggressiveness. The objective was to determine risk factors for TE during ALL induction (TEind) therapy and whether TEind is associated with treatment refractoriness. This retrospective coh...

Introduction Childhood obesity can result in a variety of adverse health outcomes and it has been associated with inferior survival in children and adolescents with acute lymphoblastic leukemia (ALL). With the rising incidence of childhood obesity in Canada, we seek to assess the prevalence of obesity and its prognostic significance in children and...

Background Intravenous immunoglobulins (IVIG) therapy is increasingly used in the treatment of various paediatric diseases. Data about frequency and underlying mechanisms of IVIG-related adverse events (IVIG-AEs) in children are limited. Objectives Objectives of this study were to document the incidence of IVIG-AEs in paediatric hospitalized patie...

Purpose: Post-thrombotic syndrome (PTS) is the most common complication of deep venous thrombosis (DVT). The index for the Clinical Assessment of Post-Thrombotic Syndrome in children (CAPTSure©) is a clinical tool for the diagnosis and severity rating of PTS in pediatric patients. The purpose of this study was to translate and adapt CAPTSure© for...

Thromboembolism is an infrequent complication in children with hemophilia that has been traditionally associated with the presence of a central venous access device. Novel rebalancing agents have shown promising results as prophylactic therapies to minimize the risk of bleeding but both thromboembolism and thrombotic microangiopathy have been repor...

Background: Accurate prediction of the individual risk of venous thromboembolism (VTE) remains suboptimal in children, and biomarkers are currently not used to stratify the risk of VTE in children. Objectives: To assess which biological or radiological biomarkers may predict VTE or VTE complications in children. Patients/methods: A literature...

SARS‐CoV‐2 infection (coronavirus disease 2019 [COVID‐19]) induces a stark procoagulant state, with many hospitalized adults developing thrombosis despite prophylactic anticoagulation. This study aimed to characterize hemostatic parameters and associated clinical outcomes of COVID‐19, such as thrombosis and bleeding, in children and to assess throm...

Congenital erythropoietic porphyria (CEP), a rare form of porphyria, is caused by a defect in the heme biosynthesis pathway of the enzyme uroporphyrinogen III synthase (UROS). Uroporphyrinogen III synthase deficiency leads to an accumulation of nonphysiological porphyrins in bone marrow, red blood cells, skin, bones, teeth, and spleen. Consequently...

The epidemiology of infant acute lymphoblastic leukemia (ALL), hypodiploid ALL, and mixed-phenotype acute leukemia (MPAL) in Canada is unknown. The main objective was to describe the prevalence, prognostic factors, and outcomes of three rare and high-risk ALL subtypes in Canada. This is a retrospective study using the Cancer in Young People-Canada...

Introduction: Thrombo-embolic event (TE) is a frequent complication of childhood acute lymphoblastic leukemia (cALL) and is associated with reduced survival. Overexpression of podoplanin or coagulome genes and coagulation pathway activation have been identified in cancer-induced TE but the role of leukemia environment in TE occurrence has not been...

Introduction: Persons with inherited bleeding disorders are at a substantial risk of bleeding following dental procedures. Aim: To compare the outcomes and use of haemostatic treatment pre- and post-implementation of a standardized protocol for dental procedures at a Hemophilia Treatment Centre. Methods: We conducted a retrospective cohort stu...

Thromboembolism is a major complication of nephrotic syndrome (NS). Hypoalbuminemia, loss of anticoagulant proteins, increased procoagulant proteins, hemoconcentration, and platelet activation contribute to a hypercoagulable state. Despite being well-described, the optimal management of thromboembolism in NS remains unclear. Rivaroxaban, a direct f...

Background/Objectives: A striking procoagulant state induced by SARS-CoV-2 (COVID-19) infection has been reported in adults, with many hospitalized patients developing thrombosis despite prophylactic anticoagulation. Reports on the characteristics of COVID-19-associated coagulopathy are scarce in the pediatric population and thromboprophylaxis use...

Background: The COVID-19 pandemic has had a major impact on access to health care resources. Our objective was to estimate the impact of the COVID-19 pandemic on the incidence of childhood cancer in Canada. We also aimed to compare the proportion of patients who enrolled in clinical trials at diagnosis, presented with metastatic disease or had an...

Primary Subject area Neonatal-Perinatal Medicine Background The incidence of central venous line (CVL)-related thromboembolism (TE) in neonates is rising dramatically. The mainstay of treatment in neonatal thrombosis is anticoagulant therapy. However, management of neonatal CVL-related TE is particularly complex, as the higher risk of systemic and...

Severe forms of pulmonary embolism (PE) in children are rare but cause significant morbidity and mortality. In this article, we review the pathophysiology of severe (high- and intermediate-risk) PE and suggest novel pediatric-specific risk stratifications and an acute treatment algorithm to expedite emergent decision making. We define pediatric hig...

There are conflicting data about whether the development of cancer‐associated thrombo‐embolism (TE) negatively impacts survival in children. The objective was to determine whether TE during treatment was associated with overall survival (OS) and event‐free survival (EFS) in children with acute lymphoblastic leukemia (ALL). We performed a population...

Remoteness is associated with worse survival in adults with cancer. We aimed to determine whether remoteness is associated with cancer outcomes in pediatric acute lymphoblastic leukemia (ALL). Canadian children with ALL entered in the CYP-C registry were included. The predictive impact of remoteness on overall survival (OS), relapse, and treatment-...

Introduction: Thromboembolism (TE) is a well-known complication of cancer and its treatments. The impact of TE on survival outcomes remains unclear, especially in children. We assessed whether TE development was associated with overall survival (OS) and event-free survival (EFS) in children with acute lymphoblastic leukemia (ALL). Methods: We perfo...

Background Infections are common and are a major cause of morbidity and mortality during treatment of childhood leukemia. We evaluated the cost effectiveness of levofloxacin antibiotic prophylaxis, compared to no prophylaxis, in children receiving chemotherapy for acute myeloid leukemia (AML) or relapsed acute lymphoblastic leukemia (ALL). Procedu...

Little is known about infections occurring after childhood cancer treatment. We assessed the risk of severe infection postcancer therapy in survivors of leukemia compared to other cancer types. We performed a population-based cohort study of children <15 years of age diagnosed with cancer (2001–2016), alive and relapse-free 30 days after treatment...

Background: The prevalence of children diagnosed with thrombotic events has been increasing in the last decades. The most common thrombosis risk factor in neonates, infants and children is the placement of a central venous catheter (CVC). It is unknown if anticoagulation prophylaxis with low molecular weight heparin (LMWH) decreases CVC-related th...

Objective: The objective of this study was to describe the outcome of healthy children presenting with newly-diagnosed neutropenia in an infectious context. Results: A total of 184 episodes of neutropenia were included in children aged 3 months to 5 years. There were 118 (64%) episodes of moderate neutropenia and 66 (36%) of severe neutropenia (...

Leukemia is the most common childhood cancer. While infections are a frequent and potentially severe complication while on treatment, less is known about the risk for infections following therapy completion. In this article, we propose that leukemia survivors might be at increased risk of infections following therapy completion than the general pop...

Thromboembolism (TE) is a well-recognized complication of pediatric cancer and can lead to mortality and excess morbidity. There is conflicting evidence about the effectiveness and safety of thromboprophylaxis in children. We conducted a systematic literature review and network meta-analysis of primary pharmacological thromboprophylaxis in children...

Purpose: Infections are a frequent complication during childhood leukemia treatment. Little is known about the infectious risk in survivors. We compared the relative rate (RR) of infections after treatment completion between pediatric leukemia survivors and the general population. Methods: We performed a retrospective, population-based cohort st...

The mainstay of hemophilia management has been the regular, prophylactic infusion of missing coagulation factors VIII/IX. This approach is limited by the need for frequent intravenous infusions, high cost, limited availability, and the development of inhibitory antibodies to factors VIII/IX. Numerous recent breakthroughs are addressing many of thes...

Infections are a common complication of treatment for pediatric acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Less is known about infections occurring after treatment. We performed a systematic review of the literature to assess the incidence of infections after therapy completion in children and young adults with ALL or AML....

Background: Little is known about severe pulmonary embolism in children. We aimed to report pulmonary embolism outcomes, identify risk factors for unfavourable outcomes, and evaluate the discriminative ability of two clinical-severity indices in children. Methods: In this retrospective cohort study, we included consecutive patients aged 18 years or...

There is conflicting information about the epidemiology of thromboembolism (TE) in paediatric oncology. Objectives were to describe the incidence and risk factors of TE in children with cancer. We included all children with cancer less than 15 years of age diagnosed from 2001 to 2016, treated at one of the 12 Canadian paediatric centres outside of...

Acquired von Willebrand syndrome (AVWS) is reported in high‐flow high‐shear congenital cardiac disorders. We hypothesized that the narrowed pulmonary vasculature in idiopathic pulmonary arterial hypertension (IPAH) may induce AVWS. We conducted a cross‐sectional evaluation of children with IPAH. Patients with bleeding symptoms and/or laboratory abn...

The design and quality of 30 recent hypnotherapy trials (years 2000-2008) were assessed using the checklist for evaluating a report of nonpharmacological treatment (CLEAR NPT). Randomization was adequately reported in 53% of studies. The masking of participants and care providers is not feasible in hypnotherapy studies. Assessor masking is rarely i...