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A Retrospective Study of Incidence of Venous Thromboembolism (VTE) and Prevalence of Risk Factors Associated with VTE in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience

B. Ram S, K.S. Nataraj, S. Prabhu, H. Dalal, A. Polisetty, S. Kumar, A. Shah, R.G. Karthick, M. Harimadhavan, S. Damodar

Mazumdar Shaw Medical Center, Narayana Health City, Department of Hematology, Bangalore, India

Abstract Number: PB2315

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » VTE Epidemiology

Background: Allogeneic hematopoietic stem cell transplantation (aHSCT) involves multiple complex risk factors that can place the patient under an increased risk of venous thromboembolism (VTE). Limited studies in aHSCT recipients have reported a wide range in the incidence of VTE, from 0.5% to 13%.

Aims: To study the incidence of VTE following aHSCT and to study the prevalence of risk factors commonly associated with VTE in this setting.

Methods: We studied a retrospective cohort of adult patients ≥18 years of age who underwent aHSCT between January 1, 2016, and December 31, 2019, at the Mazumdar Shaw Medical Center, Bangalore. Patient, transplant, and outcome-related factors were extracted from the transplantation database. A pharmacy and radiology record review was done to identify patients with VTE who received systemic anticoagulation.

Results: A cohort of 158 patients who underwent aHSCT in the time period mentioned were studied. The Baseline characteristics of the cohort are as shown in Table 1. The incidence of VTE was 2.5% with a median follow-up period of 5 months (Range 1 – 42 months). Two patients had upper limb deep vein thrombosis (DVT), 1 patient had thrombosis of medullary veins of the brain and, 1 patient had splanchnic vein thrombosis with a median time to development of VTE of 36 days, 18 days, and, 20 days respectively. Prevalence of risk factors such as central line, prolonged hospitalizations, myeloablative conditioning, acute or chronic graft versus host disease (GVHD), prior VTE, and family history of VTE was studied (Table 2.). The patients had a median of 3 risk factors in both the group of patients (VTE versus no VTE).

Conclusions: VTE is a rare complication following aHSCT (2.5% incidence in this study and the patients had a median of 3 risk factors) and further studies are warranted in this special population subset.

Baseline characterstics N (Total =158)
Median age (range) 34.5 years (18,69)
Males: females 101: 57
Diagnosis:  
Acute leukemias, myelodysplastic syndromes & other malignancies 135
Aplastic anemia, hemoglobinopathies & others 23
Donor type:  
Matched sibling: matched unrelated: haplo-identical 112: 9: 37
Disease status:  
First remission: second remission 98: 37

[Table 1. Baseline characteristics of patients]

Risk factors N (Total=158)
Central venous catheter (tunelled or non-tunelled) & PICC 158
Family history of VTE 0
Previous history of VTE 4
Prolonged hospitalizations (>30 days) 9
Myeloablative conditioning 73
Acute GVHD: Chronic GVHD 49: 19

[Table 2. Prevalence of risk factors for VTE]

To cite this abstract in AMA style:

Ram S B, Nataraj KS, Prabhu S, Dalal H, Polisetty A, Kumar S, Shah A, Karthick RG, Harimadhavan M, Damodar S. A Retrospective Study of Incidence of Venous Thromboembolism (VTE) and Prevalence of Risk Factors Associated with VTE in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-retrospective-study-of-incidence-of-venous-thromboembolism-vte-and-prevalence-of-risk-factors-associated-with-vte-in-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation-a-singl/. Accessed October 1, 2023.

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