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Cancer. 2005 Dec 15;104(12):2822-9.

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

Author information

  • 1James P. Wilmot Cancer Center and the Department of Medicine, University of Rochester, New York, USA. alok_khorana@URMC.rcohester.edu

Abstract

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.

Copyright 2005 American Cancer Society.

PMID:
16284987
[PubMed - indexed for MEDLINE]
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