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Venous thromboembolism in patients with chronic lymphocytic leukemia

Publication at Faculty of Medicine in Hradec Králové |
2015

Abstract

Introduction: Venous thromboembolism(VTE) is a major cause of morbidity and mortality in patients (pts) with malignant tumors. Increased risk of VTE is well described in a variety of hematologic malignancies; however, data regarding VTE in chronic lymphocytic leukemia (CLL) is very limited.

Patients and methods: We retrospectively analyzed clinical and laboratory data of 346 consecutive pts with CLL followed up at 4th Department of Internal Medicine -Hematology, University Hospital, Hradec Kralove, Czech Republic, diagnosed between 1999 and 2011 (males, 64%; median age, 64 years; low/intermediate/high Rai modified risk in 41/47/12%). Results: After a median follow-up of 72 months (range, 26-138), at least one episode of VTE occurred in 38 patients (11%).

VTE developed after a median of 34 months from CLL diagnosis. Incidence of VTE was 1.67% per patient year of follow-up.

There was a high proportion of unfavourable prognostic factors (advanced Rai stages, unmutated IgVH genes, unfavourable cytogenetics) in pts with VTE. The presence of 0/1/2/3 additional risk factors for VTE was identified in 2/16/14/6 patients.

The most common risk factors for VTE besides age (n = 24) were corticosteroid therapy (n = 13), other malignancies (n = 9) and obesity (n = 7). Recurrence of VTE was diagnosed in 7 pts.

Performance status = 2 and inherited thrombophilia were significant risk factors for VTE development in univariate and multivariate analysis. VTE was not associated with shorter overall survival.

Conclusion: Based on our results, VTE is a relatively frequent complication in patients with CLL. Although most patients had other known risk factors for VTE including CLL treatment, 29% had no risk factors or only age = 60 years.

These findings demonstrate the possible role of CLL in the development of VTE. (C) 2015 Published by Elsevier Ltd.