Baseline Thrombin Generation Test Does Not Predict Thrombotic Events in Acute Leukemia: A Monocentric Prospective...

Area of Science:

• Hematology
• Oncology
• Hemostasis and Thrombosis

Background:

• Acute leukemias (AL) present significant risks of thromboembolic and hemorrhagic complications.
• Conventional coagulation tests and platelet counts have limited predictive power for these events.
• Global coagulation assays (GCAs) offer a more comprehensive assessment of coagulation, potentially improving risk stratification.

Purpose of the Study:

• To investigate the utility of the Thrombin Generation Assay (TGA) for predicting thrombotic events in newly diagnosed adult patients with AL.
• To explore the variability of TGA parameters at diagnosis across different AL subtypes.

Main Methods:

• Prospective, single-center pilot study involving 111 newly diagnosed adult AL patients.
• Collection of baseline clinical and laboratory data, including TGA parameters.
• Monitoring of patients for thrombotic events with a median follow-up of 8.28 months.

Main Results:

• TGA values at diagnosis showed significant inter-individual and inter-subtype variability.
• Eight thrombotic events (7.2%) were reported during the follow-up period.
• No statistically significant association was found between baseline TGA parameters and the occurrence of thrombotic events (p > 0.05).

Conclusions:

• A single baseline Thrombin Generation Assay measurement may not be sufficient to predict thrombotic risk in acute leukemia patients.
• Future research should consider longitudinal TGA assessments and additional hemostatic evaluations, such as platelet function analysis, for improved risk prediction.