Venous thromboembolism incidence in hematologic malignancies

Blood Rev. 2019 Jan:33:24-32. doi: 10.1016/j.blre.2018.06.002. Epub 2018 Jun 21.


Venous thromboembolism (VTE) remains a major cause of morbidity and mortality in patients with cancer. Although some very well validated scores delineate the risk of VTE by cancer subtype and other risk factors, hematologic malignancies are underrepresented in these models. This subgroup represents a unique entity that undergoes therapy that can be thrombogenic. The overall risk of VTE in patients with leukemia depends on the use of L-asparaginase treatment, older age, comorbidities and central venous catheters. Patients with acute promyelocytic leukemia are at particularly high risk of VTE but also have an increased risk of bleeding. Patients with aggressive lymphomas have a high incidence of VTE, roughly 10%. Patients with multiple myeloma at highest risk of VTE are those receiving immunomodulatory agents such as thalidomide or lenalidomide. Allogeneic stem cell transplantation carries a risk of thrombosis, particularly in patients developing graft versus host disease. This review summarizes the incidence of VTE in leukemia, lymphoma, myeloma and stem cell transplantation and provides practical guidance for preventing and managing VTE in patients with hematologic malignancies.

Keywords: Deep vein thrombosis; Hematologic neoplasms; Leukemia; Lymphoma; Myeloma; Pulmonary embolism; Transplantation; Venous thrombosis.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Disease Management
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / diagnosis
  • Hematologic Neoplasms / epidemiology*
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Incidence
  • Thrombosis / epidemiology
  • Thrombosis / etiology
  • Thrombosis / prevention & control
  • Thrombosis / therapy
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / etiology*
  • Venous Thromboembolism / prevention & control
  • Venous Thromboembolism / therapy