ASH and ISTH Release Landmark Clinical Guidelines for Pediatric Blood Clot Prevention in Hospitalized Children

ASH and ISTH release the first evidence-based clinical guidelines to prevent life-threatening venous thromboembolism (VTE) in high-risk pediatric patients.

By: AXL Media

Published: Apr 8, 2026, 11:29 AM EDT

Source: Information for this report was sourced from EurekAlert!

Establishing a New Standard for Vulnerable Patients

In a significant move toward medical consensus, the American Society of Hematology, or ASH, and the International Society on Thrombosis and Haemostasis, or ISTH, have issued comprehensive guidelines to manage blood clot risks in children. Venous thromboembolism, known as VTE, has seen a steady rise in pediatric settings over the last several decades, particularly among children with chronic conditions like cancer or those requiring prolonged hospitalization. ASH President Robert Negrin, MD, noted that clinicians have historically lacked clear, evidence-based guidance for this medically complex group, making these new standards a vital step in improving long-term outcomes for children.

Addressing Preventable Harm in Pediatric Wards

Hospital-acquired VTE has been identified as the second leading cause of preventable harm in pediatric patients, yet preventive strategies have remained inconsistent across global institutions. Before these guidelines, medical professionals often relied on data extrapolated from adult patients, whose risk profiles do not account for the unique physiological complexities of children. By providing a dedicated framework for pediatric hematology, the societies aim to reduce life-threatening complications that can arise from deep vein thrombosis and pulmonary embolisms in high-risk pediatric environments.

Strategic Recommendations for Targeted Prophylaxis

The expert panel, which included multidisciplinary specialists and a lived experience expert, released twelve specific recommendations to guide anticoagulant use. Notably, the guidelines provide conditional recommendations suggesting that anticoagulant prophylaxis may not be necessary for children with solid cancer, trauma, or critical illnesses unless other risk factors are present. Conversely, the panel suggests the use of preventive anticoagulants for children diagnosed with antiphospholipid syndrome or those requiring long-term total parenteral nutrition, where the risk of clotting is significantly elevated.