Venous thromboembolism among Thai patients with lymphoma

  • Sithakom Phusanti Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
  • Pichika Chantrathammachart Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
  • Kochawan Boonyawat Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
  • Teeraya Puavilai Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
  • pimjai Niparuck Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
  • Suporn Chuncharunee Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
  • Pantep Angchaisuksiri
Keywords: Venous thromboembolism, Thai, patients, lymphoma

Abstract

Background: Data remains limited regarding venous thromboembolism (VTE) among Thai patients with lymphoma.
Aims: The study aimed to determine the prevalence, predictive factors, and clinical outcomes of VTE among Thai patients with lymphoma.

Methods: The study employed a nested case-control design from a cohort of 1,769 lymphoma patients treated at Ramathibodi Hospital.

Results: The prevalence of VTE was 5.1% (91 patients). Locations of VTE were deep vein thrombosis of the lower extremities (53.9%), pulmonary embolism (23.1%), splanchnic vein thrombosis (5.5%), jugular vein thrombosis (3.3%), cerebral venous thrombosis (1.1%), and VTE in > 2 sites (13.1%). Among 41 patients (45.1%), VTE occurred during treatment or up to 3 months after completing therapy whereas among 35 patients (38.4%) VTE was diagnosed before therapy. A control group of 455 patients was randomly selected from the database of lymphoma patients without VTE. Of patients with VTE vs. controls, 51.6 vs. 49.0%, respectively, were female (p = 0.64). The mean age was 57 vs. 61 years (p = 0.09), respectively. Types of lymphoma in the corresponding groups were B-cell non-Hodgkin lymphoma (NHL; 93. vs. 78.9%), T-cell NHL (5.5 vs. 11.7%), and Hodgkin disease (1.1 vs. 6.4%), respectively (p = 0.02). Using multivariate analysis, B-cell NHL type (odds ratio [OR] 4.4), bulky mass >10 cm (OR 2.2) and prechemotherapy platelet count > 350 x 109/L (OR 2.1) were independently predictive factors of VTE. The mortality rate in the study and control groups was 25.3 and 15.8%, respectively (p = 0.03).

Conclusion: Prevalence of VTE among Thai patients with lymphoma is not low. B-cell NHL type, bulky mass, and elevated prechemotherapy platelet count were predictive factors of VTE. Patients with VTE exhibited higher mortality.

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Published
2021-09-12
Section
นิพนธ์ต้นฉบับ (Original article)