Abstract Number: PB2174
Meeting: ISTH 2020 Congress
Background: Venous thromboembolism (VTE) is an important cause of morbidity and mortality among cancer patients. Comprehensive management of VTE in these patients includes not only effective treatment, but also identification of patients who will benefit from thromboprophylaxis. Khorana score (KS) is the main validated tool for VTE risk-stratification.
Aims: This study aims to determine VTE risk, using KS, in ambulatory cancer patients, and to evaluate thromboprophylaxis prescription in high-risk patients.
Methods: This is an ongoing prospective observational study (FIIT: Factor II – Thrombin) from a Portuguese central hospital, designed to develop a predictive model of VTE. Court study population includes patients with cancer diagnosis, proposed for anti-tumor treatment (chemotherapy, immunotherapy or targeted therapies). Patients with major bleeding in the last 3 months, major surgery in the last 28 days, on anticoagulation/antithrombotic therapy or previously submitted to bone marrow transplantation were excluded. Patients, disease characteristics and blood count values were collected, and KS calculated. The study was approved by local ethics committee. Informed consent was obtained prior to study inclusion.
Results: From April-November 2019, 182 patients were included with a mean age of 57±12 years, 51% were female. The majority had breast (22%), colorectal (20%) and gastric (12%) malignancies, 45% stage IV disease. According to KS, 46% were stratified as low-risk, 44% intermediate-risk and 10% high-risk. In high-risk patients 6-month VTE incidence can reach 17.7%. Results for VTE incidence in our population are expected during 2020. Although not routinely recommended, thromboprophylaxis might be offered to outpatients with KS ≥2. In the study 26.9% (n=49) patients had KS≥2, none initiated thromboprophylaxis before systemic treatment.
Conclusions: A noteworthy number of patients starting anti-tumor treatments have high-risk of VTE. Evidence for thromboprophylaxis criteria in these patients should be clarified. This prospective-study intends to develop a comprehensive risk-model adapted to current realities considering the diversity of available anti-tumor treatments.
To cite this abstract in AMA style:Lopes S, Marinho J, Vieira L, Azevedo F, Leão I, Neto E, Alonso Í, Morais L, Marques J, Barroso A, Coelho H, Mesquita E, Costa T, Ferreira D. Venous Thromboembolic Risk in Ambulatory Cancer Patients: Awareness Needed! [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/venous-thromboembolic-risk-in-ambulatory-cancer-patients-awareness-needed/. Accessed December 11, 2023.
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