Abstract Number: PB2107
Meeting: ISTH 2020 Congress
Background: Patients undergoing systemic cancer therapy are susceptible to developing venous thromboembolism (VTE). The most pertinent risk factors for the development of VTE in this population remain unclear.
Aims: This systematic review and meta-analysis aims to summarize the risk factors associated with VTE in patients with general cancers receiving systemic therapy.
Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for observational or randomized studies that used multivariate analysis adjusted for tumour type and/or metastatic disease to model the risk of VTE. Risk of bias was assessed using the Quality in Prognostic Factor Studies (QUIPS) tool and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Random-effect meta-analysis was used to pool the risk of VTE for each risk factor.
Results: From 5,988 citations, 15 eligible studies were identified. The final cohort included a total of 14,078 patients of whom 734 (5.2%) developed a VTE. The search identified 47 risk factors. The pooled hazard ratio (HR) was 1.21 (95% Confidence Interval (CI): 0.98 to 1.43, 95% Prediction Interval (PI): 0.89 to 1.52) for presence of metastatic disease, 0.83 (95% CI: 0.49 to 1.16, 95% PI: 0.28 to 1.37) for females, and 2.88 (95% CI: 1.84 to 3.91, 95% PI: 1.20 to 4.55) for Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 or more points. Commonly used chemotherapy agents, bevacizumab and platinum-based compounds had a pooled HR of 1.77 (95% CI: 0.56 to 2.97, 95% PI: 0.00 to 3.73) and 1.28 (95% CI: 0.63 to 1.92, 95% PI: 0.23 to 2.32), respectively.
Conclusions: Our review identified many risk factors, however, the evidence for association with development of VTE for most of the factors is inconclusive. ECOG performance and metastases are associated with increased risk of VTE.
To cite this abstract in AMA style:Lee S, Shenoy A, Husien M, Shi D, Parpia S, Serrano P. Risk Factors of Venous Thromboembolism in Patients Undergoing Systemic Cancer Therapy: A Systematic Review and Meta-Analysis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/risk-factors-of-venous-thromboembolism-in-patients-undergoing-systemic-cancer-therapy-a-systematic-review-and-meta-analysis/. Accessed September 29, 2023.
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