Development of a Clinical Prediction Rule for Venous Thromboembolism in Patients with Acute Leukemia

Thromb Haemost. 2020 Feb;120(2):322-328. doi: 10.1055/s-0039-3400303. Epub 2020 Jan 1.


Risk factors for venous thromboembolism in patients with solid tumors are well studied; however, studies in patients with acute leukemia are lacking. We conducted a retrospective cohort study of adult patients diagnosed with acute myeloid leukemia and acute lymphoblastic leukemia diagnosed between June 2006 and June 2017 at a tertiary care center in Canada. Potential predictors of venous thromboembolism were evaluated using logistic regression and a risk score was derived based on weighed variables and compared using survival analysis. Internal validation was conducted using nonparametric bootstrapping. A total of 501 leukemia patients (427 myeloid and 74 lymphoblastic) were included. Venous thromboembolism occurred in 77(15.3%) patients with 71 events occurring in the first year. A prediction score was derived and validated and it included: previous history of venous thromboembolism (3 points), lymphoblastic leukemia (2 points), and platelet count > 50 × 109/L at the time of diagnosis (1 point). The overall cumulative incidence of venous thromboembolism was 44% in the high-risk group (≥ 3 points) versus 10.5% in the low-risk group (0-2 points) and it was consistent at different follow-up periods (log-rank p < 0.001). We derived and internally validated a predictive score of venous thromboembolism risk in acute leukemia patients.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Blood Platelets / metabolism
  • Canada
  • Clinical Decision Rules*
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid, Acute / blood
  • Leukemia, Myeloid, Acute / complications*
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / blood
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Venous Thromboembolism / complications*
  • Venous Thromboembolism / diagnosis*