Abstract Number: PB2366
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Prophylaxis
Background: Patients with aggressive lymphomas are at higher risk for venous thromboembolic events (VTE) and mostly in ambulatory settings where thromboprophylaxis is not routinely offered. ThroLy is a risk assessment model (RAM) derived to predict the occurrence of VTE in a mixed basket of lymphomas.
Aims: In this study, we assess the clinical application of the original and a modified version of the model in a unified group of patients with diffuse large B-cell lymphoma (DLBL).
Methods: Hospital databases were searched for patients with DLBL and radiologically-confirmed VTE. Items in the ThroLy index were reviewed including previous VTE, reduced mobility, obesity, extranodal disease, mediastinal involvement, low neutrophil counts and Hemoglobin < 10.0 g/dL.
Results: A total of 378 patients, median age 48 (range: 18-90) years were recruited. Patients had high disease burden, including stage IV (42.1%) and bulky disease (29.9%). All were treated on unified guidelines; 69 (18.3%) had primary refractory disease or early relapse for which they underwent salvage chemotherapy and autologous stem cell transplantation.
Venous thromboembolic events were reported in 57 (15.1%) patients. Among 58 patients with high (>3) ThroLy score, 16 (27.6%) developed VTE compared to 30 (16.7%) among 180 patients with intermediate (2-3) risk score and only 10 (7.5%) of 134 patients with low (0-1) score, p= 0.008. Modifying the ThroLy into two risk groups; high-risk (score ≥3) and low risk (score < 3) can still segregate patients; VTE developed in 30 (20.5%) high-risk patients (n=146) compared to 26 (11.5%) in the low-risk group (n=226), p=0.042. Neutropenia (ANC < 1000), a component of the ThroLy, was encountered in only 9 (2.4%) patients.
Conclusions: ThroLy RAM can identify patients with DLBL at high risk for VTE to justify thromboprophylaxis in ambulatory settings. Model can be modified by dividing patients into two, rather than three risk groups and further simplified by omitting ANC.
To cite this abstract in AMA style:
Abdel-Razeq H, Ma'koseh M, Mansour A, Amarin R, Abu Fara A, Bater R, Manassra M, Alrwashdeh M, Zmaily M, Almomani M. The Application of the Original and a Modified Version of the ThroLy Risk Assessment Model (RAM) to Predict Venous Thromboembolic Events (VTE) in Patients with Diffuse Large B-Cell Lymphoma (DLBL) [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-application-of-the-original-and-a-modified-version-of-the-throly-risk-assessment-model-ram-to-predict-venous-thromboembolic-events-vte-in-patients-with-diffuse-large-b-cell-lymphoma-dlbl/. Accessed October 1, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-application-of-the-original-and-a-modified-version-of-the-throly-risk-assessment-model-ram-to-predict-venous-thromboembolic-events-vte-in-patients-with-diffuse-large-b-cell-lymphoma-dlbl/