The incidence and risk factors of thrombosis and the need for thromboprophylaxis in lymphoma and leukemia patients: A 9-year single-center experience

• Published in: Journal of oncology pharmacy practice Vol. 26; no. 2; pp. 386 - 396
• Main Authors: Yıldız, Abdulkerim, Albayrak, Murat, Pala, Çiğdem, Afacan Öztürk, Hacer B, Maral, Senem, Şahin, Osman, Cömert, Pınar
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-03-2020; Sage Publications Ltd
• Subjects: Bleeding; Dehydrogenases; Health risk assessment; L-Lactate dehydrogenase; Lactic acid; Leukemia; Lymphoma; Multiple myeloma; Prophylaxis; Risk factors; Thromboembolism; Thrombosis; leukemia; Thrombosis; lymphoma; thromboprophylaxis
• ISSN: 1078-1552; 1477-092X
• DOI: 10.1177/1078155219851540

Background
Patients with cancer are at increased risk of thromboembolic complications. There is no evidence-based guideline on the use of routine prophylaxis in hematological malignancies except in patients with multiple myeloma. The purpose of this study was to determine the incidence and risk factors of thrombosis and suggest a rationale for primary thromboprophylaxis in acute leukemia and lymphoma patients.
Patients and methods
A retrospective study was conducted on newly-diagnosed acute leukemia and lymphoma patients who presented at our institution from November 2009 to March 2018. The study included a total of 157 patients with acute leukemia and 238 patients with lymphoma. The groups were analyzed to determine the incidence and risk factors of thromboembolic complications.
Results
The incidence of all thrombotic complications was 10.12% (40/395) including 11.4% (18/157) in patients with acute leukemia and 9.2% (22/238) in patients with lymphoma. The majority of events occurred in the first 6 months. Acute leukemia patients with thrombosis had a higher number of comorbidities than those without thrombosis (p < 0.05). Lymphoma patients with thrombotic complications had significantly higher beta-2-microglobulin and lactate dehydrogenase levels compared to those without thrombosis (p < 0.05). Major bleeding events developed in five (3.1%) acute leukemia patients and two (0.8%) lymphoma patients. All the major bleeding events occurred when the patients were thrombocytopenic (platelet < 50,000/mm3).
Conclusions
Acute leukemia patients with any comorbidity and lymphoma patients with higher lactate dehydrogenase and beta-2-microglobulin are at high risk of developing thromboembolic complications. The prophylactic use of anticoagulant should be considered for those patients especially in the first 6 months.