Thrombosis and Anticoagulation Program

Led by Alan Michelson, MD, one of the world’s leading authorities on platelets and platelet disorders, the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center Thrombosis and Anticoagulation Program treats children with all forms of blood clots and clotting disorders. The disorders we treat in the program include pulmonary embolism, sinus venous thrombosis, deep vein thrombosis, and arterial thrombosis. Our emphasis is on preventing blood clots, especially thrombosis, before they occur and treating them if they do.

Dana-Farber/Boston Children’s is an integrated pediatric hematology and oncology partnership between Dana-Farber Cancer Institute and Boston Children’s Hospital. We offer, in one specialized program, the full spectrum of services that are needed for diagnosis, treatment and ongoing care of even the rarest and hard-to-treat conditions.

Patients seen through the Thrombosis and Anticoagulation Program are treated by a multidisciplinary team of specialists with deep expertise in the conditions we treat. Our team also includes pediatric subspecialists with extensive experience treating blood clots and a designated nurse who specializes in medications that thin the blood and prevent clots from forming.

Our approach to thrombosis

Thrombosis is often found accidentally but mostly because patients develop signs and symptoms of a blood clot. Our doctors perform a physical exam to evaluate symptoms, such as swelling, pain at the location of the suspected clot, and redness and warmth. We confirm the diagnosis through diagnostic imaging studies, including ultrasound, MRI, and CT scans. Thrombophilia, a group of disorders that increase a child’s tendency to develop excessive and dangerous blood clots, is diagnosed through a blood sample. A blood test determines if a child is clotting normally and will identify any abnormalities in certain protein levels in the blood. Genetic tests are used to check for hereditary disorders.

Treatment is based on several factors, but most children with thrombosis are treated with anti-coagulation therapy (“blood-thinners”). Our anticoagulation service provides ongoing monitoring and medical management of children on anticoagulation medications. These medications include oral agents such as Coumadin (warfarin), intravenous heparin, subcutaneous injections of a low molecular weight heparin such as enoxaparin (Lovenox) or dalteparin (Fragmin), or antiplatelet agents such as aspirin, clopidogrel (Plavix), or prasugrel (Effient).