Venous thromboembolism incidence in hematologic malignancies

Venous thromboembolism (VTE) remains a major cause of morbidity and mortality in patients with cancer. Although some very well validated scores delineate the risk of VTE by cancer subtype and other risk factors, hematologic malignancies are underrepresented in these models. This subgroup represents...

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Bibliographic Details
Published in:Blood reviews 2019-01, Vol.33, p.24-32
Main Authors: Kekre, Natasha, Connors, Jean M.
Format: Article
Language:English
Subjects:
Algorithms
Deep vein thrombosis
Disease Management
Hematologic neoplasms
Hematologic Neoplasms - complications
Hematologic Neoplasms - diagnosis
Hematologic Neoplasms - epidemiology
Hematologic Neoplasms - therapy
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic Stem Cell Transplantation - methods
Humans
Incidence
Leukemia
Lymphoma
Myeloma
Pulmonary embolism
Thrombosis - epidemiology
Thrombosis - etiology
Thrombosis - prevention & control
Thrombosis - therapy
Transplantation
Venous Thromboembolism - epidemiology
Venous Thromboembolism - etiology
Venous Thromboembolism - prevention & control
Venous Thromboembolism - therapy
Venous thrombosis
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Summary:Venous thromboembolism (VTE) remains a major cause of morbidity and mortality in patients with cancer. Although some very well validated scores delineate the risk of VTE by cancer subtype and other risk factors, hematologic malignancies are underrepresented in these models. This subgroup represents a unique entity that undergoes therapy that can be thrombogenic. The overall risk of VTE in patients with leukemia depends on the use of L-asparaginase treatment, older age, comorbidities and central venous catheters. Patients with acute promyelocytic leukemia are at particularly high risk of VTE but also have an increased risk of bleeding. Patients with aggressive lymphomas have a high incidence of VTE, roughly 10%. Patients with multiple myeloma at highest risk of VTE are those receiving immunomodulatory agents such as thalidomide or lenalidomide. Allogeneic stem cell transplantation carries a risk of thrombosis, particularly in patients developing graft versus host disease. This review summarizes the incidence of VTE in leukemia, lymphoma, myeloma and stem cell transplantation and provides practical guidance for preventing and managing VTE in patients with hematologic malignancies.
ISSN:0268-960X
1532-1681
DOI:10.1016/j.blre.2018.06.002