Acquired and inherited risk factors for developing venous thromboembolism in cancer patients receiving adjuvant chemotherapy: a prospective trial

被引:78
作者
Mandala, M. [1 ]
Barni, S. [2 ]
Prins, M. [3 ]
Labianca, R.
Tondini, C.
Russo, L. [4 ]
Milesi, A.
Cremonesi, M. [2 ]
Zaccanelli, M. [5 ]
Regonesi, C. [5 ]
Moro, C.
Falanga, A. [4 ]
机构
[1] Osped Riuniti Bergamo, Med Oncol Unit, Dept Hematol & Oncol, I-24126 Bergamo, Italy
[2] Treviglio Hosp, Div Med Oncol, Bergamo, Italy
[3] Univ Maastricht, Acad Hosp Maastricht, Dept Clin Epidemiol & Med Technol Assessment, Maastricht, Netherlands
[4] Osped Riuniti Bergamo, Ctr Thrombosis & Hemostasis, Dept Hematol & Oncol, Div Immunohematol Transfus Med, I-24126 Bergamo, Italy
[5] Treviglio Hosp, Dept Clin Pathol, Unit Transfus & Hematol, Treviglio, Italy
关键词
adjuvant chemotherapy; risk factors; venous thromboembolism; THROMBOSIS; THERAPY; MUTATIONS; WOMEN;
D O I
10.1093/annonc/mdp354
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Acquired and inherited risk factors for venous thromboembolism (VTE) and the incidence of symptomatic VTE were investigated in patients on adjuvant chemotherapy for breast or gastrointestinal cancer (GI). Patients and methods: In a prospective observational study (January 2003 and February 2006), 199 GI (82 women/117 men; age range, 26-84 years) and 182 breast (180 women/2 men; age range, 29-85 years) cancer patients were enrolled and followed-up for symptomatic VTE during adjuvant chemotherapy. The effect of acquired (i.e. age, chemotherapy, tumour histotype, history of thrombosis, body mass index and smoking) and inherited risk factors [i.e. antithrombin, protein C (PC), protein S, homocysteine, activated PC resistance, factor V Leiden (FVL) and prothrombin (PT) mutations) was prospectively evaluated. Results: Overall, 30 VTE events (7.87%) were recorded: 28 (7.35%) during treatment and 2 (0.52%) during the subsequent follow-up. Among all the 381 cancer patients, FVL was detected in 14 cases (3.67%) and PT mutation in 10 cases (2.62%). Multivariate analysis showed a significant association between the development of VTE and both thrombocytosis [hazard ratio (HR) 1.65; 95% confidence interval (CI), 1.04-2.637, P < 0.0341] and a prior episode of thrombosis (HR 7.6; 95% CI, 1.77-33.1, P < 0.006). FVL and PT mutations were not associated with the risk for VTE. Conclusion: The present data indicate thrombocytosis and history of thrombosis as risk factors for development of a thrombotic event during adjuvant chemotherapy in patients with malignant diseases.
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收藏
页码:871 / 876
页数:6
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