Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients

Lymphoma patients are at increased risk of thromboembolic events but thromboprophylaxis in these patients is largely underused. We sought to develop and validate a simple model, based on individual clinical and laboratory patient characteristics that would designate lymphoma patients at risk for thr...

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Bibliographic Details
Published in:American journal of hematology 2016-10, Vol.91 (10), p.1014-1019
Main Authors: Antic, Darko, Milic, Natasa, Nikolovski, Srdjan, Todorovic, Milena, Bila, Jelena, Djurdjevic, Predrag, Andjelic, Bosko, Djurasinovic, Vladislava, Sretenovic, Aleksandra, Vukovic, Vojin, Jelicic, Jelena, Hayman, Suzanne, Mihaljevic, Biljana
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Hematology
Humans
Lymphoma - complications
Lymphoma - diagnosis
Male
Middle Aged
Models, Cardiovascular
Predictive Value of Tests
Risk Assessment
Risk Factors
Sensitivity and Specificity
Thromboembolism - diagnosis
Thromboembolism - etiology
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Summary:Lymphoma patients are at increased risk of thromboembolic events but thromboprophylaxis in these patients is largely underused. We sought to develop and validate a simple model, based on individual clinical and laboratory patient characteristics that would designate lymphoma patients at risk for thromboembolic event. The study population included 1,820 lymphoma patients who were treated in the Lymphoma Departments at the Clinics of Hematology, Clinical Center of Serbia and Clinical Center Kragujevac. The model was developed using data from a derivation cohort (n = 1,236), and further assessed in the validation cohort (n = 584). Sixty‐five patients (5.3%) in the derivation cohort and 34 (5.8%) patients in the validation cohort developed thromboembolic events. The variables independently associated with risk for thromboembolism were: previous venous and/or arterial events, mediastinal involvement, BMI>30 kg/m2, reduced mobility, extranodal localization, development of neutropenia and hemoglobin level 3). For patients classified at risk (intermediate and high‐risk scores), the model produced negative predictive value of 98.5%, positive predictive value of 25.1%, sensitivity of 75.4%, and specificity of 87.5%. A high‐risk score had positive predictive value of 65.2%. The diagnostic performance measures retained similar values in the validation cohort. Developed prognostic Thrombosis Lymphoma – ThroLy score is more specific for lymphoma patients than any other available score targeting thrombosis in cancer patients. Am. J. Hematol. 91:1014–1019, 2016. © 2016 Wiley Periodicals, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/ajh.24466