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Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study.

Publication ,  Journal Article
Khorana, AA; Francis, CW; Culakova, E; Lyman, GH
Published in: Cancer
December 15, 2005

BACKGROUND: The incidence of venous thromboembolism (VTE) is increased in cancer, but little information is available about risk factors in cancer patients on chemotherapy. METHODS: We analyzed data from a prospective, multicenter observational study to determine the frequency and risk factors for VTE in ambulatory cancer patients initiating a new chemotherapy regimen. The association of VTE with clinical variables was characterized using univariate and multivariate analysis. RESULTS: Among 3003 patients treated with at least one cycle of chemotherapy, VTE occurred in 58 (1.93%) over a median follow-up of 2.4 months (0.8%/mo). The incidence varied significantly by site of cancer (P = 0.01) with highest rates in upper gastrointestinal (2.3%/mo) and lung cancer (1.2%/mo), and lymphoma (1.1%/mo). An elevated prechemotherapy platelet count was significantly associated with an increased rate of VTE (P for trend = 0.005). The incidence of VTE was 3.98% (1.66%/mo) for patients with a prechemotherapy platelet count > or = 350,000, compared with 1.25% (0.52%/mo) for patients with platelet counts of < 200,000 (P for trend=0.0003). In multivariate analysis, a prechemotherapy platelet count of > or = 350,000/mm(3) (adjusted OR 2.81, 95% CI 1.63-4.93, P = 0.0002), site of cancer, hemoglobin < 10 g/dL or use of erythropoietin, and use of white cell growth factors in high-risk sites of cancer were significantly associated with VTE. CONCLUSIONS: Symptomatic VTE is a frequent complication of chemotherapy. The prechemotherapy platelet count is a unique risk factor and can help identify high-risk patients for future trials of thromboprophylaxis.

Duke Scholars

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

December 15, 2005

Volume

104

Issue

12

Start / End Page

2822 / 2829

Location

United States

Related Subject Headings

  • United States
  • Thromboembolism
  • Survival Rate
  • Sex Distribution
  • Severity of Illness Index
  • Risk Factors
  • Prospective Studies
  • Prognosis
  • Probability
  • Oncology & Carcinogenesis
 

Citation

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Khorana, A. A., Francis, C. W., Culakova, E., & Lyman, G. H. (2005). Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study. Cancer, 104(12), 2822–2829. https://doi.org/10.1002/cncr.21496
Khorana, Alok A., Charles W. Francis, Eva Culakova, and Gary H. Lyman. “Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study.Cancer 104, no. 12 (December 15, 2005): 2822–29. https://doi.org/10.1002/cncr.21496.
Khorana AA, Francis CW, Culakova E, Lyman GH. Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study. Cancer. 2005 Dec 15;104(12):2822–9.
Khorana, Alok A., et al. “Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study.Cancer, vol. 104, no. 12, Dec. 2005, pp. 2822–29. Pubmed, doi:10.1002/cncr.21496.
Khorana AA, Francis CW, Culakova E, Lyman GH. Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study. Cancer. 2005 Dec 15;104(12):2822–2829.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

December 15, 2005

Volume

104

Issue

12

Start / End Page

2822 / 2829

Location

United States

Related Subject Headings

  • United States
  • Thromboembolism
  • Survival Rate
  • Sex Distribution
  • Severity of Illness Index
  • Risk Factors
  • Prospective Studies
  • Prognosis
  • Probability
  • Oncology & Carcinogenesis