Identifying Clinical Predictors of VTE in AML and MDS

Researchers conducted a study to discern clinical predictors for the development of venous thromboembolism (VTE) in patients with hematologic malignancies, which are represented poorly in validated risk scoring systems. The findings were presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting.

This retrospective analysis, conducted by Lauren Gabriele Banaszak and colleagues, consisted of 547 patients, of which 304 had acute myeloid leukemia (AML), and 243 had myelodysplastic syndrome (MDS), all of whom were diagnosed from Jan. 2010 through Dec. 2021. The researchers utilized univariate and multivariable logistic regression, as well as log-binomial regression to analyze the data.

The overall prevalence of VTE was 14%, with AML patients more likely to experience VTE compared to those with MDS (19.1% vs. 7.8%, RR = 2.4, 95% CI, 1.5-4.1, p <0.001). Factors associated with VTE were higher body mass index (BMI, p =0.022), induction chemotherapy (p =0.001), and younger age (p =0.001). The researchers observed that possessing a mutation in a chromatin modification gene (ASXL1/2, EED, EZH2, KMT2A) was associated with an 87% reduction in the risk of developing VTE (RR = 0.13, 95% CI 0.01-0.58, p =0.002). Overall, the researchers noted that the mortality rate for those who experienced VTE was only half the rate of those who never experienced VTE (95% CI, 35-69%, p <0.001).

“At our institution, the total incidence of VTE was higher than previously described, which underscores the importance of elucidating risk factors of VTE in order to prevent this complication,” the investigators concluded.