Abstract Number: PB2375
Meeting: ISTH 2020 Congress
Background: Lymphoma patients are at higher risk for venous thromboembolic events (VTE). Almost 25% of patients will have refractory disease or early relapse and majority of such patients undergo salvage chemotherapy and autologous stem cell transplantation.
Aims: Data on VTE in this setting is scarce. In this study, we investigate the prevalence and factors that may increase the risk of VTE in such patients.
Methods: Medical records were searched for patients with a lymphoma diagnosis and radiologically-confirmed VTE. Known risk factors for VTE were reviewed.
Results: A total of 216 patients, median age: 31 (range: 19-60) years were recruited. Most patients (n=140: 64.8%) had Hodgkin’s lymphoma while 50 (23.1%) others had diffuse large B-cell lymphoma (DLBL). In total, 36 (16.7%) patients had VTE mostly as upper extremity DVT (n=28, 77.8%); 13 (46.4%) of them were related to central venous catheter (CVC). Thrombosis rates were higher among patients with high LDH (29.2% vs. 5.9%, p< 0.001), those with mediastinal involvement (25.9% vs. 11.5%, p=0.025) and in patients with longer hospital stay (22.1% vs.9.5%, p=0.036). Patients who failed to achieve complete remission (CR) post-transplant and patients with high ThroLy risk score had higher rates of VTE, but was not statistically significant; (25.0% vs. 12.8%, p=0.064) and (21.3% vs. 13.1%, p=0.094), respectively. Type of lymphoma (Hodgkin's vs. Non-Hodgkin's), tumor size, body mass index, mobilizing regimen and disease status prior to transplant had no impact on VTE rates. In multivariate analysis, high LDH (OR: 7.66; 95% CI: 2.79-21.04, p< 0.001) and mediastinal involvement (OR, 3.64; 95% CI:1.53-8.70, p=0.002) were associated with significantly higher rates of VTE.
Conclusions: Patients with relapsed Hodgkin’s and Non-Hodgkin’s lymphoma undergoing salvage chemotherapy and stem cell transplantation are at higher risk for VTE especially in those with high LDH and mediastinal involvement. If no contraindications exist, thromboprophylaxis might be considered in these settings.
To cite this abstract in AMA style:Ma'koseh M, Alrwashdeh M, Al Far R, Edaily S, Bater R, Zmaily M, Almomani M, Abdel H. Prevalence and Predictors of Venous Thromboembolic Events (VTE) in Patients Undergoing Salvage Chemotherapy and Autologous Stem Cell Transplantation for Relapsed Lymphomas [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/prevalence-and-predictors-of-venous-thromboembolic-events-vte-in-patients-undergoing-salvage-chemotherapy-and-autologous-stem-cell-transplantation-for-relapsed-lymphomas/. Accessed October 1, 2023.
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