Older age, White or Black race, and other factors were identified as predictors of venous thromboembolism (VTE) in patients with acute myeloid leukemia or acute lymphoblastic leukemia (AML/ALL), according to a poster presented at the 63rd ASH Annual Meeting & Exposition.

Researchers conducted a retrospective cohort study using electronic medical record data from over 300 major US hospitals. The primary endpoint of the study was the incidence of cancer-associated VTE within a year of diagnosis, which included deep vein thrombosis, pulmonary embolism, and superficial vein thrombosis.

Inclusion criteria were patients between 20-79 years of age who were diagnosed with AML/ALL within the past 5 years, which produced a sample size of 19,050 patients. Of these, 1150 patients met the primary endpoint; the incidence of VTE within a year of diagnosis was 8.14%.

Authors noted baseline characteristics as well as patient Khorana scores, a validated measurement used to guide prophylactic anticoagulation in high-risk patients.

Factors associated with increased risk VTE included the following:

• older age;
• White or Black race;
• smoking;
• prior VTE, which had the strongest association with increased risk (OR 7.46);
• presence of central venous catheter;
• Factor V Leiden; and
• antineoplastic agent or PegA use.

Additional potential risk factors included obesity, anemia, erythropoietin use, and leukocytosis.

“Interestingly, both low platelet counts (<50 x 109/L) and high platelet counts (>350 x 109/L) were associated with increased cancer associated VTE…which emphasizes the need to consider surveillance or thromboprophylaxis strategies in AML/ALL patients with thrombocytopenia with presumed high bleeding risk,” researchers concluded.

Factors that seemed to predict protection against VTE included younger age and Asian ethnicity.

Authors concluded that “further studies will be fundamental to meet the unmet need for a specific risk stratification system(s) for patients with AML/ALL.”

Reference:
Grinsztejn E, Nayak LV, Kapoor S. Predictors of venous thromboembolism in patients with acute myeloid leukemia or acute lymphoblastic leukemia. Poster presented at: 63rd ASH Annual Meeting & Exposition; December 11-14, 2021: Atlanta, GA.