THROMBOTIC COMPLICATIONS IN HEMATOLOGIC MALIGNANCIES
(Abstract release date: 05/19/16)
EHA Library. Popescu M. 06/09/16; 135104; PB2204
Mrs. Mihaela Popescu
Contributions
Contributions
Abstract
Abstract: PB2204
Type: Publication Only
Background
In patients with cancer there is an increased risk of thromboembolism, especially in certain types of solid tumors and hematologic malignancies. Occurrence of venous thromboembolism in patients with cancer is linked to a hypercoagulable state due to synthesis of pro-coagulants factors or local hypoxia. The risk of thrombotic complications increases during chemotherapy, hospitalization or surgery. Thrombosis is a frequent complication in acute leukemia as well, but its pathogenesis is not entirely known, being probably determined by a combination of factors related to the patient, disease and treatment regimens used.
Aims
To analyze the causes of thrombotic complications in patients with hematologic malignancies, excluding those with myeloproliferative neoplasms, multiple myeloma treated with immunomodulatory agents and acute promyelocytic leukemia, known to be associated with increased risk of thrombosis. Also, we excluded cases of catheter-related thrombosis.
Methods
We analyzed data of 41 patients with hematologic malignancies admitted in our institution during a period of 9 years which presented with at least one episode of thrombosis.
Results
There were 23 females and 18 males. The diagnosis distribution was: 4 cases of acute myeloid leukemia, 1 case of hairy cell leukemia, 1 case of acute lymphoblastic leukemia, 1 case of myelodysplastic syndrome, 2 cases of Hodgkin Lymphoma, 27 cases of Non-Hodgkin Lymphoma, 5 cases of multiple myeloma. The median age was 65 years (ranges from 37-81 years). After location of thrombosis, there were 37 cases of venous thrombosis, 4 cases of arterial thrombosis, 2 cases of DIC. Additional risk factors besides cancer were identified in 8 cases, including recent history of splenectomy, secondary thrombocytosis, phospholipidic syndrome, presence of clone of paroxysmal nocturnal hemoglobinuria, status post-autologous stem cell transplantation and chronic venous insufficiency. No additional risk factors were identified in the other patients. Inherited thrombophilia was not tested, but personal and family history was not suggestive for thrombophilia in the reported cases.
Conclusion
Thrombosis is the second cause of death and a major cause of morbidity in cancer patients, and improving antithrombotic prophylaxis and treatment in this subset of patients may have important prognostic implications. An important issue is to identify patients at risk in order to establish proper prophylaxis. Score models were elaborated based on site of cancer, hemoglobin value, platelet and leukocyte count, and body mass index. However, in a subset of patients additional risk factors besides cancer could not be identified. Furthermore, in some patients thrombosis occur in the setting of severe thrombocytopenia. In this context, it could be important to identify some biological markers for thrombosis, such as the well known and used D-Dimer, and other studied markers, but not yet in clinical use, such as tissue factor, P-selectin or VEGF.We present an important lot of patients with hematologic malignancies and thrombosis, of note that most of these patients had no identifiable risk factors of thrombosis. Moreover some of these patients developed thrombosis in the setting of severe thrombocytopenia in the absence of DIC. We find important to identify biological markers useful in patients with cancer to predict thrombosis. We intend to screen patients with hematologic malignancies and thrombosis for D-Dimer, tissue factor and VEGF.
Session topic: E-poster
Keyword(s): Cancer, Risk factor, Thrombosis
Type: Publication Only
Background
In patients with cancer there is an increased risk of thromboembolism, especially in certain types of solid tumors and hematologic malignancies. Occurrence of venous thromboembolism in patients with cancer is linked to a hypercoagulable state due to synthesis of pro-coagulants factors or local hypoxia. The risk of thrombotic complications increases during chemotherapy, hospitalization or surgery. Thrombosis is a frequent complication in acute leukemia as well, but its pathogenesis is not entirely known, being probably determined by a combination of factors related to the patient, disease and treatment regimens used.
Aims
To analyze the causes of thrombotic complications in patients with hematologic malignancies, excluding those with myeloproliferative neoplasms, multiple myeloma treated with immunomodulatory agents and acute promyelocytic leukemia, known to be associated with increased risk of thrombosis. Also, we excluded cases of catheter-related thrombosis.
Methods
We analyzed data of 41 patients with hematologic malignancies admitted in our institution during a period of 9 years which presented with at least one episode of thrombosis.
Results
There were 23 females and 18 males. The diagnosis distribution was: 4 cases of acute myeloid leukemia, 1 case of hairy cell leukemia, 1 case of acute lymphoblastic leukemia, 1 case of myelodysplastic syndrome, 2 cases of Hodgkin Lymphoma, 27 cases of Non-Hodgkin Lymphoma, 5 cases of multiple myeloma. The median age was 65 years (ranges from 37-81 years). After location of thrombosis, there were 37 cases of venous thrombosis, 4 cases of arterial thrombosis, 2 cases of DIC. Additional risk factors besides cancer were identified in 8 cases, including recent history of splenectomy, secondary thrombocytosis, phospholipidic syndrome, presence of clone of paroxysmal nocturnal hemoglobinuria, status post-autologous stem cell transplantation and chronic venous insufficiency. No additional risk factors were identified in the other patients. Inherited thrombophilia was not tested, but personal and family history was not suggestive for thrombophilia in the reported cases.
Conclusion
Thrombosis is the second cause of death and a major cause of morbidity in cancer patients, and improving antithrombotic prophylaxis and treatment in this subset of patients may have important prognostic implications. An important issue is to identify patients at risk in order to establish proper prophylaxis. Score models were elaborated based on site of cancer, hemoglobin value, platelet and leukocyte count, and body mass index. However, in a subset of patients additional risk factors besides cancer could not be identified. Furthermore, in some patients thrombosis occur in the setting of severe thrombocytopenia. In this context, it could be important to identify some biological markers for thrombosis, such as the well known and used D-Dimer, and other studied markers, but not yet in clinical use, such as tissue factor, P-selectin or VEGF.We present an important lot of patients with hematologic malignancies and thrombosis, of note that most of these patients had no identifiable risk factors of thrombosis. Moreover some of these patients developed thrombosis in the setting of severe thrombocytopenia in the absence of DIC. We find important to identify biological markers useful in patients with cancer to predict thrombosis. We intend to screen patients with hematologic malignancies and thrombosis for D-Dimer, tissue factor and VEGF.
Session topic: E-poster
Keyword(s): Cancer, Risk factor, Thrombosis
Abstract: PB2204
Type: Publication Only
Background
In patients with cancer there is an increased risk of thromboembolism, especially in certain types of solid tumors and hematologic malignancies. Occurrence of venous thromboembolism in patients with cancer is linked to a hypercoagulable state due to synthesis of pro-coagulants factors or local hypoxia. The risk of thrombotic complications increases during chemotherapy, hospitalization or surgery. Thrombosis is a frequent complication in acute leukemia as well, but its pathogenesis is not entirely known, being probably determined by a combination of factors related to the patient, disease and treatment regimens used.
Aims
To analyze the causes of thrombotic complications in patients with hematologic malignancies, excluding those with myeloproliferative neoplasms, multiple myeloma treated with immunomodulatory agents and acute promyelocytic leukemia, known to be associated with increased risk of thrombosis. Also, we excluded cases of catheter-related thrombosis.
Methods
We analyzed data of 41 patients with hematologic malignancies admitted in our institution during a period of 9 years which presented with at least one episode of thrombosis.
Results
There were 23 females and 18 males. The diagnosis distribution was: 4 cases of acute myeloid leukemia, 1 case of hairy cell leukemia, 1 case of acute lymphoblastic leukemia, 1 case of myelodysplastic syndrome, 2 cases of Hodgkin Lymphoma, 27 cases of Non-Hodgkin Lymphoma, 5 cases of multiple myeloma. The median age was 65 years (ranges from 37-81 years). After location of thrombosis, there were 37 cases of venous thrombosis, 4 cases of arterial thrombosis, 2 cases of DIC. Additional risk factors besides cancer were identified in 8 cases, including recent history of splenectomy, secondary thrombocytosis, phospholipidic syndrome, presence of clone of paroxysmal nocturnal hemoglobinuria, status post-autologous stem cell transplantation and chronic venous insufficiency. No additional risk factors were identified in the other patients. Inherited thrombophilia was not tested, but personal and family history was not suggestive for thrombophilia in the reported cases.
Conclusion
Thrombosis is the second cause of death and a major cause of morbidity in cancer patients, and improving antithrombotic prophylaxis and treatment in this subset of patients may have important prognostic implications. An important issue is to identify patients at risk in order to establish proper prophylaxis. Score models were elaborated based on site of cancer, hemoglobin value, platelet and leukocyte count, and body mass index. However, in a subset of patients additional risk factors besides cancer could not be identified. Furthermore, in some patients thrombosis occur in the setting of severe thrombocytopenia. In this context, it could be important to identify some biological markers for thrombosis, such as the well known and used D-Dimer, and other studied markers, but not yet in clinical use, such as tissue factor, P-selectin or VEGF.We present an important lot of patients with hematologic malignancies and thrombosis, of note that most of these patients had no identifiable risk factors of thrombosis. Moreover some of these patients developed thrombosis in the setting of severe thrombocytopenia in the absence of DIC. We find important to identify biological markers useful in patients with cancer to predict thrombosis. We intend to screen patients with hematologic malignancies and thrombosis for D-Dimer, tissue factor and VEGF.
Session topic: E-poster
Keyword(s): Cancer, Risk factor, Thrombosis
Type: Publication Only
Background
In patients with cancer there is an increased risk of thromboembolism, especially in certain types of solid tumors and hematologic malignancies. Occurrence of venous thromboembolism in patients with cancer is linked to a hypercoagulable state due to synthesis of pro-coagulants factors or local hypoxia. The risk of thrombotic complications increases during chemotherapy, hospitalization or surgery. Thrombosis is a frequent complication in acute leukemia as well, but its pathogenesis is not entirely known, being probably determined by a combination of factors related to the patient, disease and treatment regimens used.
Aims
To analyze the causes of thrombotic complications in patients with hematologic malignancies, excluding those with myeloproliferative neoplasms, multiple myeloma treated with immunomodulatory agents and acute promyelocytic leukemia, known to be associated with increased risk of thrombosis. Also, we excluded cases of catheter-related thrombosis.
Methods
We analyzed data of 41 patients with hematologic malignancies admitted in our institution during a period of 9 years which presented with at least one episode of thrombosis.
Results
There were 23 females and 18 males. The diagnosis distribution was: 4 cases of acute myeloid leukemia, 1 case of hairy cell leukemia, 1 case of acute lymphoblastic leukemia, 1 case of myelodysplastic syndrome, 2 cases of Hodgkin Lymphoma, 27 cases of Non-Hodgkin Lymphoma, 5 cases of multiple myeloma. The median age was 65 years (ranges from 37-81 years). After location of thrombosis, there were 37 cases of venous thrombosis, 4 cases of arterial thrombosis, 2 cases of DIC. Additional risk factors besides cancer were identified in 8 cases, including recent history of splenectomy, secondary thrombocytosis, phospholipidic syndrome, presence of clone of paroxysmal nocturnal hemoglobinuria, status post-autologous stem cell transplantation and chronic venous insufficiency. No additional risk factors were identified in the other patients. Inherited thrombophilia was not tested, but personal and family history was not suggestive for thrombophilia in the reported cases.
Conclusion
Thrombosis is the second cause of death and a major cause of morbidity in cancer patients, and improving antithrombotic prophylaxis and treatment in this subset of patients may have important prognostic implications. An important issue is to identify patients at risk in order to establish proper prophylaxis. Score models were elaborated based on site of cancer, hemoglobin value, platelet and leukocyte count, and body mass index. However, in a subset of patients additional risk factors besides cancer could not be identified. Furthermore, in some patients thrombosis occur in the setting of severe thrombocytopenia. In this context, it could be important to identify some biological markers for thrombosis, such as the well known and used D-Dimer, and other studied markers, but not yet in clinical use, such as tissue factor, P-selectin or VEGF.We present an important lot of patients with hematologic malignancies and thrombosis, of note that most of these patients had no identifiable risk factors of thrombosis. Moreover some of these patients developed thrombosis in the setting of severe thrombocytopenia in the absence of DIC. We find important to identify biological markers useful in patients with cancer to predict thrombosis. We intend to screen patients with hematologic malignancies and thrombosis for D-Dimer, tissue factor and VEGF.
Session topic: E-poster
Keyword(s): Cancer, Risk factor, Thrombosis
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