A retrospective study of venous thromboembolism in acute leukemia patients treated at the University of Texas MD Anderson Cancer Center

Cancer Medicine - Tập 4 Số 1 - Trang 27-35 - 2015
Khanh Dang Vu1, Nhiem Luong2, Julie C. Hubbard3, Ali Zalpour4, Stefan Faderl5, Deborah A. Thomas5, Daisy Yang4, Hagop M. Kantarjian5, Michael H. Kroll6
1Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
2The University of Texas Health Science Center at Houston, Houston, Texas
3Annapolis Oncology Center, Annapolis, Maryland
4Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
5Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
6Department of Pulmonary Medicine, Section of Thrombosis and Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas

Tóm tắt

AbstractThe purpose was to determine the incidence and prevalence of venous thromboembolism (VTE) in acute leukemia patients from our institution. We conducted a retrospective study on newly diagnosed acute leukemia patients who presented at our institution from November 1999 to May 2005. Descriptive statistics and cross‐tabulation were used to describe patient characteristics. Measures of morbidity were used to address VTE risk. Chi‐square testing, Fisher's exact testing, Mann–Whitney analyses, or median testing were used to determine between‐group differences. Data analyses were conducted using Stata version 11 (Stata Corp., College Station, TX). Two hundred and ninety‐nine patients with acute lymphoblastic leukemia (ALL) and 996 patients with acute myeloid leukemia (AML) were included. After excluding patients diagnosed with VTE prior to or at the time of leukemia diagnosis, during the mean time follow‐up period of 2.5 years (range: 0.0025–10.3 years), the overall incidence rate of VTE was 3.7 per 100 person‐years: 4.2 per 100 person‐years for ALL and 3.4 per 100 person‐years for AML. Among all patients, the majority (80.6%) developed VTE within 12 months after diagnosis and during thrombocytopenia. The most common VTE was central venous catheter (CVC)‐associated upper‐extremity deep venous thrombosis. Pulmonary embolism occurred in 15% of ALL patients and 8% of AML patients. VTE recurred in 20.7% of ALL patients and 18.6% of AML patients. VTE occurs frequently in patients with acute leukemia. Studies are needed to identify risk factors for the development and recurrence of VTE among patients with acute leukemia and to establish more effective methods for preventing and treating VTEs in leukemia patients who have thrombocytopenia and/or CVC.

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Tài liệu tham khảo

10.1161/01.CIR.0000078468.11849.66

10.1200/JCO.2009.23.5788

10.1097/COC.0b013e3181b01b17

10.1016/j.amjmed.2005.02.028

10.1111/j.1538-7836.2007.02374.x

Gross J. S., 1988, Autopsy study of the elderly institutionalized patient. Review of 234 autopsies, Arch. Intern. Med., 148, 173, 10.1001/archinte.1988.00380010175018

10.1200/JCO.2013.49.1118

10.1056/NEJM198012113032411

10.1182/blood-2006-10-053736

10.1016/S0049-3848(07)70137-8

10.3109/10428199909145951

10.1016/j.beha.2008.12.001

10.1200/JCO.2009.22.8197

10.1016/j.ddmec.2012.02.001

10.1111/j.1538-7836.2005.01467.x

10.1097/00005792-199909000-00001

Lee A. Y. Y., 2003, Venous thromboembolism and cancer: risks and outcomes, Circulation, 107, I17

10.1182/blood-2008-08-175745

10.1016/S0049-3848(12)70023-3

10.1001/archinte.166.4.458

10.2174/157016110791330799

10.1016/S0049-3848(10)70024-4

10.1055/s-2007-976179

Falanga A., 2007, Management of thrombohemorrhagic syndromes (THS) in hematologic malignancies, ASH Educ. Program Book 2007, 165

10.1038/sj.bjc.6602945

10.1056/NEJM199904013401303

10.1002/ajh.23158

10.1016/j.thromres.2004.07.016

10.1200/JCO.2005.03.8877

10.1200/JCO.2000.18.3.547

10.1056/NEJM198802183180703

10.1080/10428190410001693588

10.1111/j.1365-2141.2010.08524.x

10.1016/S0140-6736(09)60220-8

10.1200/JCO.2009.22.6126

10.1056/NEJMoa025313

10.1016/S0049-3848(12)70035-X