The chair and co-chairs and more than 200 participants/ subcommittee members were present. Issues discussed were as follows:

1. Epidemiology, diagnosis, management and prophylaxis of venous thrombosis during pregnancy: This topic was presented by M. Hellgren. She stated that hereditary or acquired thrombophilia increases the risk of VTE and that screening for thrombophilia should be performed following obstetric complications such as early-onset severe preeclampsia, abruptio placentae, severe IUGR, repeated fetal loss and IUFD. In addition, M. Hellgren pointed out that objective diagnosis verification by suitable imaging methods is mandatory. Treatment modalities of VTE during pregnancy, e.g. i.v. infusion of unfractionated heparin (UFH) followed by s.c. UFH or low molecular mass heparin (LMMH) until delivery were discussed as well as the use of prolonged anticoagulant treatment with oral anticoagulants or s.c. LMMH post partum. Thromboprophylaxis with s.c. LMMH is suggested during pregnancy for women with previous VTE and thrombophilia, recurrent VTE, hereditary antithrombin deficiency without previous VTE, and antiphospholipid antibody syndrome. In addition to M. Hellgren, B. Brenner presented data indicating that inherited thrombophilia is associated not only with gestational thromboembolism but also with fetal loss, intrauterine growth retardation, preeclampsia and placental abruption. The antithrombotic therapy in this setting was further discussed. In addition, the placenta as the target organ for future research was pointed out.
2. Prothrombotic risk factors and imaging methods in ischemic stroke in children: F. Kirkham (London) and R. Sträter (Münster) reported on ischaemic stroke in children. Both underlined the importance of prothrombotic risk factors at the onset of the disease and the possible role in recurrent stroke. In addition, they pointed out that stroke types may influence recurrent stroke and that an adequate imaging work-up is mandatory in classifying stroke children. The future of therapeutic multicentre studies was discussed.
3. Deep venous thrombosis in children: Dr. Mitchell reported the results from the PARKAA Trial (Prophylactic antithrombin replacement therapy in kids with acute lymphoblastic leukemia treated with asparaginase) in which imaging methods, i.e. venography and ultrasound, were compared. She concluded from the data obtained that venography was superior to ultrasound in detecting thrombosis in the central venous system, whereas ultrasound was more sensitive in detecting venous thrombosis in the jugular veins. M. Briones&T. Abshire discussed a management report on catheter-related thromboses in children older than 12 months of age. M. Peters presented an objective new but not yet validated scoring system in adolescent patients with deep venous thrombosis for the use of heparin prophylaxis. This scoring system should be validated in different ethnic groups before it can be used routinely. M. Manco-Johnson reviewed data on TPA thrombolysis in children and concluded that the value of TPA thrombolysis compared to standard anticoagulant therapy in reducing morbidity should be studied in prospective clinical trials. P. Massicotte reported on bone mineral density in a pediatric cohort patients suffering from DVT receiving long-term warfarin therapy. This paper gave evidence that BMD remains significantly decreased, with bone formation more affected than bone resorption, resulting in a net result of increased bone resorption. The need for further studies in the field were discussed. M. Peters reported on postthrombotic syndrome in children after venous thrombosis. Data from their study suggested that approximately two-thirds of children with DVT of the limbs are at risk of developing postthrombotic syndrome, with a higher risk in children carrying prothrombotic defects, suffering from recurrent thrombosis, and with a first onset during adolescence. The need to study compression stockings in these children was discussed.
4. Normal values of hemostatic parameters in the pediatric population: H.G. Koch reported on fasting homocysteine concentrations in healthy children and pediatric patients with thromboembolism. He reported that children carrying Hcy concentrations > the 90^th age-dependent percentile have an increased risk of developing thromboembolism. In addition, in the upper Hcy quartile the odds ratio for suffering thrombosis was significantly increased also in neonates, infants and children. V. Balasa reported on prothrombin and PAI-1 in healthy children. He stated that a significant relationship between the G20201A allele and elevated plasma prothrombin levels was not recorded among children. The PAI-1 4G/4G polymorphism was associated with elevated PAI-1 activity levels in children. The PAI-1 genotype was an independent, significant determinant of PAI-1 antigen levels in children as well. The 4G allele of the PAI-1 gene is more commonly present among Caucasians than among African-Americans variants and its role in pediatric thromboembolism has to be evaluated in future studies. S. Israels reported on the evaluation of platelet function in children using the PFA-100 platelet function analyzer. Mean closure times (CTs) are significantly shorter in neonates, and slightly, but not significantly, longer in healthy children than in adults, and similar normal ranges can be used for screening children with bleeding disorders. CTs can be used for simple and accurate evaluation of the response to desmopressin in children with vWD and platelet function abnormalities. Patients with type 1 vWD consistently showed correction of CTs, while type 2 patients showed variable results that correlated with changes in ristocetin cofactor activity (RCoF). Some patients with partial storage pool deficiency or secretion defects also showed CT correction following desmopressin. For patients with vWD not responsive to desmopressin, vWFactor concentrates did not correct the CT, although levels of vWAntigen and RCoF were increased. In comparison to older children and adults, mean CTs of cord blood from healthy neonates are significantly shorter. E.F. Grabowski reported on platelet adhesion/aggregation in flowing blood in pediatric hemostatic disorders. He concluded that platelet function under physiologic flow conditions is clearly more informative regarding hemostasis (or thrombosis) than platelet count or aggregation in platelet-rich plasma, and may very well correlate more significantly with clinical bleeding (or thrombosis). Nicole Schlegel introduced the results of a study on integrin expression and function in neonatal platelets. She reported that a significant defect in GPIIbIIIa expression and function and a specific GPIb behavior were registered in neonatal platelets. B. Kehrel introduced also normal age-dependent values for the distribution of platelet membrane glycoproteins in neonates, children and young adults. She demonstrated first results showing that, despite neonatal platelets expressing normal amounts of glycoprotein (GP) Ia/IIa, GPVI and GPIb/V/IX, neither CD62-P expression nor CD63 expression nor fibrinogen binding was induced by collagen (up to 1.5 µg/ml), whereas 0.5 µg/ml induced maximal activation of adult (age 20-35 years, n=25) platelets. In contrast ristocetin-induced vWF-binding to neonatal platelets was increased significantly. Even 0.3 to 0.5 mg/ml ristocetin induced maximal vWF-binding. 0.8 to 1.0 mg/ml ristocetin is needed to induce maximal vWF-binding in normal adult platelets. She concluded that knowledge of normal platelet functions in children are essential for the reliable diagnosis of platelet function disorders.
5. Influence of factor VIIa on thrombin generation: A. Chan reported the on influence of exogenous factor VIIa on thrombin generation in cord plasma of full-term and preterm infants. He found that FVIIa enhanced IIa generation in plasma from different age groups, with the effect being more pronounced in plasma from preterm newborns, possibly due to increased levels of plasma TF.
6. Hemophilia: M. Manco-Johnson and P. Petrini introduced the development of international standards for assessment of physical outcomes in children with hemophilia. The WFH and three new scales were compared in 43 hemophilic children. The three new scales all showed better correlation with the WFH pain instrument than the original WFH physical examination instrument (p< 0.01 for each of the new instruments vs. > 0.05 for the WFH instrument). In addition, results of the new Colorado child physical examination instrument best conformed with a normal distribution (p=0.35) and displayed better overall statistical performance. This instrument should be studied further in prospective, longitudinal clinical trials of young children.
7. Thrombocytopenia: J.. Bussel reported on a series of intracranial hemorrhages in ITP. In addition, he introduced a newly developed registry of non-immune thrombocytopenia. The Non-Immune Thrombocytopenia registry will begin in the United States, Canada, and Europe. The intention is to identify cases of chronic thrombocytopenia that are not ITP, including amegakaryocytic thrombocytopenia (CAMT).