Incidence, risk factors, and outcomes of patients with monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia who develop venous thromboembolism.

IF 5.5 2区 医学 Q1 HEMATOLOGY Journal of Thrombosis and Haemostasis Pub Date : 2024-09-27 DOI:10.1016/j.jtha.2024.08.029
Amber B Koehler, Kari G Rabe, Daniel J Crusan, Timothy G Call, Sara J Achenbach, Paul J Hampel, Saad S Kenderian, Jose F Leis, Yucai Wang, Eli Muchtar, Mazie Tsang, Talal Hilal, Ricardo Parrondo, Kent R Bailey, Wei Ding, Rachel Bailen, Susan M Schwager, Min Shi, Curtis A Hanson, Susan L Slager, Neil E Kay, Aneel A Ashrani, Sameer A Parikh
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Abstract

Background: The incidence, risk factors, and outcomes of venous thromboembolism (VTE) in patients with chronic lymphocytic leukemia (CLL) and monoclonal B-cell lymphocytosis (MBL) are not well described.

Objectives: We aimed to determine the clinical characteristics, risk factors, and outcomes of incident VTE in patients with newly diagnosed MBL/CLL and compare the incidence to the age- and sex-matched general population.

Methods: Using the Mayo Clinic CLL Database, we identified 946 patients with newly diagnosed MBL/CLL between 1998 and 2021. Incidence of VTE was identified by querying the electronic health record for VTE-specific International Classification of Diseases-9 and -10 codes and reviewing results of radiographic studies.

Results: Eighty patients developed VTE. The incidence of VTE in patients with newly diagnosed MBL/CLL was ∼1% per year. In multivariable analyses, prior history of VTE (hazard ratio [HR]: 5.33; 95% CI: 1.93-14.68, P = .001) and high/very high-risk CLL-International Prognostic Index score (HR: 2.63; 95% CI: 1.31-5.26; P = .006) were associated with an increased risk of VTE; receipt of CLL treatment or occurrence of nonhematologic malignancy was not. Development of VTE was associated with shorter overall survival (HR: 1.82, 95% CI: 1.30-2.55) after adjusting for age, sex, prior history of VTE, and Rai stage. The age- and sex-adjusted VTE incidence rate for patients with MBL/CLL and no prior history of VTE (n = 904) was 1254 per 100 000 person-years compared with 204 per 100 000 person-years in the general population, reflecting a 5.9-fold increase.

Conclusion: Our study demonstrates a 6-fold increased risk of VTE in patients with MBL/CLL compared with the age- and sex-matched general population.

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单克隆 B 细胞淋巴细胞增多症和慢性淋巴细胞白血病患者发生静脉血栓栓塞的发病率、风险因素和预后。
背景:慢性淋巴细胞白血病(CLL)和单克隆B细胞淋巴细胞增多症(MBL)患者静脉血栓栓塞症(VTE)的发病率、风险因素和预后尚未得到很好的描述:我们旨在确定新确诊的 MBL/CLL 患者发生 VTE 的临床特征、风险因素和结果,并将其发生率与年龄和性别匹配的普通人群进行比较:利用梅奥诊所 CLL 数据库,我们确定了 1998-2021 年间新确诊的 946 名 MBL/CLL 患者。通过查询电子病历中与 VTE 相关的 ICD-9 和 ICD-10 编码并查看放射学检查结果,确定了 VTE 的发生率:结果:80 名患者发生了 VTE。新确诊的 MBL/CLL 患者的 VTE 发生率为每年 1%。在多变量分析中,既往VTE病史(HR:5.33,95% CI:1.93-14.68,P=0.001)和高/极高风险CLL-国际预后指数评分(HR:2.63,95% CI:1.31-5.26,P=0.006)与VTE风险增加有关;接受CLL治疗或发生非血液恶性肿瘤则与之无关。在调整了年龄、性别、VTE既往史和莱氏分期后,VTE的发生与较短的总生存期相关(HR:1.82,95% CI:1.30-2.55)。经年龄和性别调整后,无VTE既往史的MBL/CLL患者(n=904)的VTE发病率为每10万人年1,254例,而普通人群为每10万人年204例,增加了5.9倍:我们的研究表明,与年龄和性别匹配的普通人群相比,MBL/CLL 患者发生 VTE 的风险增加了 6 倍。
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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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