Abstract Number: LPB0138
Meeting: ISTH 2021 Congress
Background: Venous thromboembolism (VTE) is a frequent complication of cancer. Thrombocytopenia is common in cancer, either due to the disease itself or a side effect of therapy. Retrospective studies have evaluated either full-dose anticoagulation with transfusion support or dose-modified anticoagulation. We performed a prospective multi-center observational study to assess bleeding and thrombosis outcomes in cancer patients with thrombocytopenia diagnosed with acute VTE.
Aims: To determine the cumulative incidence of recurrent VTE and hemorrhage in patients with cancer who developed acute VTE in the setting of thrombocytopenia according to anticoagulation regimen administered (full-dose with platelet transfusion support versus dose-modified anticoagulation). Enoxaparin was the only low molecular weight heparin used, and full dose was defined as > 1.5 mg/kg/day.
Methods: A prospective, multi-center observational cohort study was performed in patients with active malignancy with acute VTE and concurrent thrombocytopenia (platelet count < 100,000/mcL). Patients were monitored for 60 days for the development of recurrent VTE and hemorrhage. Major hemorrhage was defined by ISTH criteria. All clinical outcomes were adjudicated by two physicians.
A total of 121 patients were enrolled (Table). Baseline characteristics differed in some aspects, e.g. cancer diagnosis. In patients who initially received therapeutic anticoagulation, the cumulative incidence of major hemorrhage at 30 days was 6.7% (95% CI, 0.01-12.4%) and 0% in the dose-modified anticoagulation group (sHR 2.18, 95% CI 1.21-3.93). The cumulative incidence of recurrent VTE at 30 days in patients who initially received full-dose anticoagulation was 4.1% (95% CI, 0 8.8%) and 0% in patients who initially received dose-modified anticoagulation.
Conclusions: In patients with cancer who develop VTE in the setting of thrombocytopenia, dose-modified anticoagulation was associated with a lower rate of major hemorrhage than full-dose anticoagulation. Dose-modified anticoagulation was not associated with an increased rate of recurrent VTE.
To cite this abstract in AMA style:Carney B, Wang T-, Ren S, George G, Al Homssi A, Gaddh M, Connolly G, Shah V, Bogue T, Bartosic A, Neuberg D, Baumann Kreuziger L, Zwicker J. Results of a Prospective, Observational, Multi-center Cohort Study of Venous Thromboembolism Outcomes in Thrombocytopenic Cancer Patients (TROVE Study) [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/results-of-a-prospective-observational-multi-center-cohort-study-of-venous-thromboembolism-outcomes-in-thrombocytopenic-cancer-patients-trove-study/. Accessed September 24, 2021.
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