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Venous thromboembolism in patients with diffuse large B-cell lymphoma

Rami S Komrokji1, Nikhil P Uppal, Alok A Khorana

  • 1Department of Medicine, University of Cincinnati and Cincinnati Veterans Administration Medical Center, Cincinnati, OH 45267-0501, USA. komrokrs@ucmail.uc.edu

Leukemia & Lymphoma
|July 15, 2006
PubMed

Insights

Venous thromboembolism (VTE) affects 12.8% of diffuse large B-cell lymphoma (DLBCL) patients, often at diagnosis or during initial chemotherapy. This complication is linked to significantly worse survival outcomes in DLBCL patients.

Area of Science:

  • Hematology
  • Oncology
  • Vascular Medicine

Background:

  • Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
  • Venous thromboembolism (VTE) is a known complication in cancer patients, but its frequency in DLBCL requires further elucidation.

Purpose of the Study:

  • To determine the incidence of VTE in patients diagnosed with DLBCL.
  • To identify risk factors associated with VTE in DLBCL.
  • To assess the impact of VTE on survival in DLBCL patients.

Main Methods:

  • Retrospective review of 211 DLBCL patient records from 1990-2001 at a tertiary care hospital.
  • Exclusion of patients with transformed lymphoma, CNS lymphoma, HIV-related lymphoma, or incomplete records.
  • Identification of symptomatic VTE events confirmed by imaging, occurring at diagnosis or during initial treatment.

Main Results:

  • VTE occurred in 12.8% (27/211) of DLBCL patients.
  • High International Prognostic Index (IPI) scores were associated with increased VTE risk; Stage I disease showed low risk.
  • VTE was present at diagnosis in 37% and occurred during the first three chemotherapy cycles in 82% of affected patients.
  • Median survival was significantly lower for patients with VTE (1.04 years) compared to those without (5.2 years).

Conclusions:

  • VTE is a frequent complication in DLBCL, particularly occurring at diagnosis and during early chemotherapy.
  • VTE in DLBCL patients is associated with a poorer prognosis and reduced survival.
  • Risk stratification using factors like IPI may help identify DLBCL patients at higher risk for VTE.

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