Assessing the risk of venous thromboembolism in patients with haematological cancers using three prediction models

EL-Sayed, Hanaa Ali; Othman, Maha; Azzam, Hanan; Bucciol, Regan; Ebrahim, Mohamed Awad; EL-Agdar, Mohammed Ahmed Mohammed Abdallah; Tera, Yousra; Sakr, Doaa H.; Ghoneim, Hayam Rashad; Selim, Tarek El-Sayed

doi:10.1007/s00432-023-05475-7

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…It is suspected that the incidence of DVT is higher among patients with T-ALL and lymphoma compared to those with Bcell ALL. 13,54,55 In addition, the increased risk of DVT in adults might also be explained by a potential decline in anticoagulant and fibrinolytic parameters associated with aging. 10 The absence of blinding for the investigator, who possessed knowledge regarding the primary location of DVT in all cases is a limiting factor as well.…”

Section: Discussionmentioning

confidence: 99%

Sequelae and post‐thrombotic syndrome after venous thromboembolism in acute lymphoblastic leukemia survivors treated on the NOPHO ALL2008 protocol

Dam,

Lynggaard,

Jónsson

et al. 2024

Pediatric Blood & Cancer

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The treatment of acute lymphoblastic leukemia (ALL) is frequently complicated by toxicity, including venous thromboembolism (VTE) affecting roughly 8% of patients. VTE can lead to post‐thrombotic syndrome (PTS), a group of signs and symptoms developed as a complication to deep venous thrombosis (DVT), imposing risk of permanent disability and reduced quality of life (QoL). PTS prevalence ranges from 0% to 70%, reflecting very heterogenous cohorts and assessment tools. We aimed to estimate sequelae, including PTS and QoL in children and adults (<45 years old) who had a DVT during ALL treatment. PTS and QoL scores were obtained through use of Villalta and Modified Villalta Scale, PedsQL, and Short Form‐36 questionnaires. The cohort comprised 20 children (<18 years) and seven adults (median age: 12.9 years, range: 2–44 years) at the time of DVT diagnosis. In total, 25 ALL survivors underwent PTS examination. The examination took place when survivors were 7–48 years (median age: 20.3 years, median follow‐up time 6.8 years). QoL was assessed correlating cases with three matching ALL survivors without VTE. Two adults (15.4%) showed mild or moderate PTS. Eight children (66.7%) were diagnosed with mild PTS, while three cases had collaterals as sole symptoms. Pain or symptoms affecting daily life were reported by 16%. No difference in QoL was found (p = .9). This study underscores the need for comprehensive population‐based investigations with validation of PTS instruments in ALL survivors.

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Section: Discussionmentioning

confidence: 99%

Sequelae and post‐thrombotic syndrome after venous thromboembolism in acute lymphoblastic leukemia survivors treated on the NOPHO ALL2008 protocol

Dam,

Lynggaard,

Jónsson

et al. 2024

Pediatric Blood & Cancer

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“…It is well known that solid tumors are associated with thromboembolic complications [28], but recent studies have shown that the incidence of thrombosis may be equally high, if not even higher, in patients with malignant hematological disorders [29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Retinal Vessel Analysis and Microvascular Abnormalities in Patients with Philadelphia-Negative Chronic Myeloproliferative Neoplasms

Roszkowska,

Leanza,

Aragona

et al. 2024

JCM

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Background: Philadelphia-negative chronic myeloproliferative neoplasms are a group of clonal hematopoietic disorders including polycythemia vera, essential thrombocythemia, and primary myelofi-brosis. These neoplasms are characterized by an increased risk of thrombotic complications. Several studies have highlighted that the study of vessels of the retina offers the opportunity to visualize, in vivo, the damage to microcirculation that is common in various systemic pathologies. Methods: in our study, forty patients underwent an ophthalmological examination, using non-invasive imaging tech-niques, for analyses of their retinal vascularization. The objective was to correlate the findings ob-tained from this study of the retina with different markers of thrombotic risk, to demonstrate the usefulness of studying retinal vessels as a possible new prognostic biomarker of thrombotic risk in patients affected by Philadelphia-negative chronic myeloproliferative neoplasms. Results: retinal imaging demonstrated changes in the microcirculation, with a reduced vascular density of the deep and superficial capillary plexuses with respect to a normal group, and a correlation between retinal changes and blood parameters. Conclusions: additional research will allow us to determine whether retinal changes in individuals with chronic myeloproliferative neoplasms could be predictive of the development of thrombotic events in these subjects.

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“…Ramos-Esquivel et al recently found the Khorana score to perform an accurate categorization of VTE risk in ambulatory Hispanic patients who were newly diagnosed with solid tumors and were receiving systemic chemotherapy [35]. El-Sayed et al reported a calculated VTE occurrence probability of 87.5% when using the Khorana score at cut-off levels ≥ 3 in patients with hematological malignancy [36]. However, many researchers found the universal use of the Khorana score in primary thromboprophylaxis risk assessment inappropriate.…”

Section: Vte Risk Assessment Using Scoresmentioning

confidence: 99%

“…The eligible patients were those with advanced cancer who underwent chemotherapy or had started chemotherapy in the previous three months [52]. In hematological malignancy, the calculated probability of VTE occurrence was the same when using Vienna CATS or Khorana score at cut-off values of ≥3 [36]. A value more than or equal to 3 of the Vienna CATS risk score was significantly associated with VTE complications in Japanese patients with advanced cancer who were receiving chemotherapy [53].…”

Section: Vte Risk Assessment Using Scoresmentioning

confidence: 99%

Novel Insights in Venous Thromboembolism Risk Assessment Methods in Ambulatory Cancer Patients: From the Guidelines to Clinical Practice

Drăgan,

Drăgan

2024

Cancers

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Many cancer patients will experience venous thromboembolism (VTE) at some stage, with the highest rate in the initial period following diagnosis. Novel cancer therapies may further enhance the risk. VTE in a cancer setting is associated with poor prognostic, a decreased quality of life, and high healthcare costs. If thromboprophylaxis in hospitalized cancer patients and perioperative settings is widely accepted in clinical practice and supported by the guidelines, it is not the same situation in ambulatory cancer patient settings. The guidelines do not recommend primary thromboprophylaxis, except in high-risk cases. However, nowadays, risk stratification is still challenging, although many tools have been developed. The Khrorana score remains the most used method, but it has many limits. This narrative review aims to present the current relevant knowledge of VTE risk assessment in ambulatory cancer patients, starting from the guideline recommendations and continuing with the specific risk assessment methods and machine learning models approaches. Biomarkers, genetic, and clinical features were tested alone or in groups. Old and new models used in VTE risk assessment are exposed, underlining their clinical utility. Imaging and biomolecular approaches to VTE screening of outpatients with cancer are also presented, which could help clinical decisions.

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Assessing the risk of venous thromboembolism in patients with haematological cancers using three prediction models

Cited by 5 publications

References 34 publications

Sequelae and post‐thrombotic syndrome after venous thromboembolism in acute lymphoblastic leukemia survivors treated on the NOPHO ALL2008 protocol

Sequelae and post‐thrombotic syndrome after venous thromboembolism in acute lymphoblastic leukemia survivors treated on the NOPHO ALL2008 protocol

Retinal Vessel Analysis and Microvascular Abnormalities in Patients with Philadelphia-Negative Chronic Myeloproliferative Neoplasms

Novel Insights in Venous Thromboembolism Risk Assessment Methods in Ambulatory Cancer Patients: From the Guidelines to Clinical Practice

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