Abstract Number: PB2102
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis
Background: Anticoagulation (AC) of patients with venous thromboembolism (VTE) accompanied by cancer is associated with a higher rate of anticoagulation failure and higher risk of bleeding complications compared to VTE patients without cancer.
Aims: To compare VTE recurrence, major and clinically relevant non-major bleeding (CRNMB), and mortality amongst different types of cancer.
Methods: Consecutive patients enrolled in the Mayo Clinic VTE Registry between March 2013 and November 2019 with acute VTE were followed prospectively. With the exception of brain cancer, all other cancers were grouped separately if there were more than a hundred patients. Patient outcomes were assessed in person, by mailed questionnaire, or scripted phone interview.
Results: Of the 2798 patients enrolled, 1256 (44.9%) had active cancer including: gastrointestinal (n=244), genitourinary and ovarian (GU/OV, n=201), pancreatic (n=154), hematologic (n=136), lung (n=104), brain (n=47), and other cancers (n=370). Proportion of cancer patients treated with direct oral anticoagulants varied from 63% (pancreatic) to 47% (hematologic). The highest rate of VTE recurrence was in pancreatic (9.70) followed by hematologic (7.24) groups compared to patients with no cancer (NoCa) (2.95) but no difference in lung cancer (6.74, p=0.06) and GU/OV
(2.02, p=0.55) (Table). Mortality rates were higher in all types of cancer compared to NoCa. Major bleeding rates were significantly higher in all groups except pancreatic and hematological cancers. Patients with lung cancer had higher, and patients with hematological malignancies lower, rates of CRNMB compared to NoCa patients.
Conclusions: Significant differences in clinical outcomes of anticoagulation for VTE exist amongst patients with different cancers. Pancreatic cancer is associated with the highest mortality and VTE recurrence while major bleeding and CRNMB are not different compared to NoCa patients. Lung cancer has the highest rate of major bleeding and CRNMB while VTE recurrence is not significantly different.
| Cancer type (Outcomes: rates 100-person years) | VTE recurrence | Mortality | Major Bleeding | CRNMB |
| Gastrointestinal | 5.86 | 51.26 | 6.78 | 7.25* |
| GU/OV | 2.02* | 55.91 | 11.18 | 10.12* |
| Pancreatic | 9.70 | 79.64 | 3.47* | 6.01* |
| Hematologic | 7.24 | 26.80 | 2.08* | 1.35^ |
| Lung | 6.74* | 77.48 | 11.44 | 13.84 |
| Brain | No events | 55.23 | 8.05 | 5.35* |
| Other cancers | 5.99 | 41.71 | 9.06 | 6.40* |
| No Cancer | 2.95 | 8.44 | 2.62 | 7.08 |
[Outcomes by cancer type (* No difference with NoCa, ^ lower than NoCa).]
To cite this abstract in AMA style:
Wysokinski W, Vlazny DT, McBane RD, Hodge DO, Froehling DA, Houghton DE, Peterson LG, Casanegra AI. Clinical Outcome of Anticoagulation for Acute Venous Thromboembolism Associated with Different Types of Cancer [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/clinical-outcome-of-anticoagulation-for-acute-venous-thromboembolism-associated-with-different-types-of-cancer/. Accessed September 24, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/clinical-outcome-of-anticoagulation-for-acute-venous-thromboembolism-associated-with-different-types-of-cancer/