Identification and characterization of recurrent venous thrombosis in cancer patients Meeting Abstract

Authors: Weber, C.; Adel, N. G.; Riedel, E.; Soff, G. A.
Abstract Title: Identification and characterization of recurrent venous thrombosis in cancer patients
Meeting Title: 52nd Annual Meeting of the American Society of Hematology (ASH)
Abstract: Background: Venous thromboembolism (VTE) is a common. cause of morbidity and mortality in, cancer patients. Standard of care for treatment is Low Molecular Weight Heparin, hip: recurrence of VTE remains a concern. We performed a retrospective analysis of our institutional experience, to characterize the patients who had a recurrence, of VTE while on therapeutic doses of Dalteparin.Objectives: 1. To determine the VTE recurrence rate for cancer patients on therapeutic Dalteparin. 2. To elucidate potential risk factors for recurrence. 3. To determine the impact of recurrent VTE on overall survival.Methods: Patients beginning treatment for VTE with dalteparin between 1/1/2008 and 12/10/2009 were retrospectively identified through the hospital's electronic medical records system and cases of recurrent VTE were characterized. Overall survival was estimated using the Kaplan-Meier method and the influence of VTE recurrence on overall survival was analyzed as a time-dependent covariate using a Cox proportional hazards model.Results: 1,392 patients, treated for VTE with dalteparin were included in this study. 34 recurrent VTE episodes were identified. The overall incidence of recurrent thrombosis by six months was 2.3% (95% CI: 1.7%-3.3%). Older age was significantly associated with recurrence (p=0.04). Lung cancer patients had a significantly elevated risk of recurrence (5.6%, p=0.03). No other cancer types were associated with a significant trend to increased recurrent VIE rates. The incidence of recurrent VTE was higher among females compared to males (3.0% vs. 1.6%), although this trend was-not statistically significant (P = 0.08). After adjusting for gender, sex and cancer diagnosis, developing a recurrent VTE was associated with a 3.0-fold hazard ratio of death (< 0.0001).Conclusions: The rate of recurrent VTE in cancer patients at MSKCC is low in comparison with previously published reports. However, we identified both;older age and lung cancer diagnosis as statistically significant risk factors for recurrent VTE; Females also experienced a higher rate of recurrent thrombosis when compared to males, although this result was not statistically significant. The hazard ratio for death was three times that for a patient with recurrent thrombosis when compared to one without subsequent,. VTE, suggesting recurrence of VTE remains an important influence on cancer-associated mortality.
Keywords: blood pressure; hemodynamic effect; systemic vascular resistance; linear-dosage response; vaso-vagal instability
Journal Title: Blood
Volume: 116
Issue: 21
Meeting Dates: 2010 Dec 4-7
Meeting Location: Orlando, FL
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2010-11-19
Start Page: 1363
Language: English
PROVIDER: biosis
PUBMED: 22276300
Notes: --- - Meeting Abstract: 3328 - 52nd Annual Meeting of the American-Society-of-Hematology (ASH) - Orlando, FL, USA - December 04 -07, 2010 - Amer Soc Hematol - "Source: Biosis"