The Incidence of Venous Thromboembolism and Impact on Survival in Hodgkin Lymphoma

Venous thromboembolic events are associated with high morbidity and mortality in malignancy patients. We should be aware in terms of venous thromboembolism in patients who have involvement of spleen, advanced stage disease, or a central venous line, especially initial high fibrinogen levels, even with a good performance status. Background: Thrombosis increase the acute and long-term morbidity and mortality in malignancy patients. We analyzed venous thromboembolism (VTE) in patients with Hodgkin lymphoma, the impact of VTE on survival, predisposing factors for VTE, and predicting value of Khorana and ThroLy score models. Patients and Methods: We included 150 adult patients with Hodgkin lymphoma between January 2010 and 2018 at our university hospital. Results: VTE was observed in 31 patients (20.7%). The types of VTE were 18 upper and 3 lower extremity deep vein thrombosis and 10 pulmonary embolism (1 with lower extremity deep vein thrombosis). Twenty-nine patients developed VTE during the treatment with a median time of episode as 5 months. In logistic regression analysis, a body mass index of >32 kg/m(2), high fibrinogen levels, initial thrombocytosis and leukocytosis, splenic and extranodal involvement, presence of a central venous line, advanced stage, line of treatment status of thromboprophylaxis, VTE timing, and better Eastern Cooperative Oncology Group performance scores were observed to be related with VTE. Kaplan Meier survival analysis showed a negative impact of VTE on survival. Khorana and ThroLy risk assessment models were found predictive for VTE (P = .000 and P = .003, respectively), although only ThroLy score was associated with the survival. Conclusion: Thromboprophylaxis and precautions for VTE in patients with Hodgkin lymphoma according to validated risk assessment models can improve prognosis and quality of life owing to the impact of VTE on survival in the study. (C) 2020 Elsevier Inc. All rights reserved.