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Thromb Haemost 2020; 120(02): 322-328
DOI: 10.1055/s-0039-3400303
Stroke, Systemic or Venous Thromboembolism
Georg Thieme Verlag KG Stuttgart · New York

Development of a Clinical Prediction Rule for Venous Thromboembolism in Patients with Acute Leukemia

Fatimah Al-Ani
1   Division of Hematology, Department of Medicine, Western University, London, Ontario, Canada
,
Yimin Pearl Wang
1   Division of Hematology, Department of Medicine, Western University, London, Ontario, Canada
,
Alejandro Lazo-Langner 
1   Division of Hematology, Department of Medicine, Western University, London, Ontario, Canada
2   Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
› Institutsangaben
Funding This study was funded by the Canadian Venous Thromboembolism Clinical Trials and Outcomes Research (CanVECTOR) Network which receives grant funding from the Canadian Institutes for Health Research (Grant/Award number “CDT 142654”). F.A.-A was supported by a fellowship from the CanVECTOR Network. A.L.-L. is an investigator of the CanVECTOR Network.
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Publikationsverlauf

21. Mai 2019

26. September 2019

Publikationsdatum:
01. Januar 2020 (online)

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Abstract

Risk factors for venous thromboembolism in patients with solid tumors are well studied; however, studies in patients with acute leukemia are lacking. We conducted a retrospective cohort study of adult patients diagnosed with acute myeloid leukemia and acute lymphoblastic leukemia diagnosed between June 2006 and June 2017 at a tertiary care center in Canada. Potential predictors of venous thromboembolism were evaluated using logistic regression and a risk score was derived based on weighed variables and compared using survival analysis. Internal validation was conducted using nonparametric bootstrapping. A total of 501 leukemia patients (427 myeloid and 74 lymphoblastic) were included. Venous thromboembolism occurred in 77(15.3%) patients with 71 events occurring in the first year. A prediction score was derived and validated and it included: previous history of venous thromboembolism (3 points), lymphoblastic leukemia (2 points), and platelet count > 50 × 109/L at the time of diagnosis (1 point). The overall cumulative incidence of venous thromboembolism was 44% in the high-risk group (≥ 3 points) versus 10.5% in the low-risk group (0–2 points) and it was consistent at different follow-up periods (log-rank p < 0.001). We derived and internally validated a predictive score of venous thromboembolism risk in acute leukemia patients.

Keywords

acute leukemia - venous thromboembolism - prediction - score