美国老年急性淋巴细胞白血病患者静脉血栓栓塞症的相关风险因素和死亡率

Q4 Medicine Thrombosis Update Pub Date : 2023-12-21 DOI:10.1016/j.tru.2023.100155

Ambarina S. Faiz , Ashwin Sridharan , Shuang Guo , Yong Lin , Claire S. Philipp

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引用次数: 0

摘要

目的我们的研究旨在探讨接受不同治疗方案的老年急性淋巴细胞白血病（ALL）患者发生静脉血栓栓塞（VTE）的风险因素以及与 VTE 相关的死亡率。方法我们分析了美国 SEER-Medicare 数据库（2007-2015 年）中年龄≥65 岁确诊为 ALL 患者的数据。数据按治疗方案分为三组：化疗：使用抗代谢药物、蒽环类药物、烷化剂或长春花生物碱；其他治疗：使用皮质类固醇/酪氨酸激酶抑制剂，不进行化疗；不进行治疗。结果在 1088 名老年 ALL 患者的队列中，17.4% 的患者确诊为 VTE。在接受化疗的 159 例患者中，27.7% 的患者被诊断出 VTE；在接受其他治疗的 328 例患者中，16.2% 的患者被诊断出 VTE；在未接受任何治疗的 601 例患者中，15.3% 的患者被诊断出 VTE（P< 0.001）。与未接受任何治疗的患者相比，接受化疗的患者发生 VTE 的调整后几率为 1.59（95 % CI，1.02-2.48），接受其他治疗的患者发生 VTE 的几率为 ORa = 0.88（95 % CI，0.60-1.30）。VTE与ALL患者的死亡风险无关（HRa = 0.85，95 % CI，0.70-1.02）。

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Risk factors and mortality associated with venous thromboembolism in the elderly US population with acute lymphocytic leukemia

Objective

The purpose of our study was to examine risk factors for venous thromboembolism (VTE) and VTE associated mortality in elderly acute lymphocytic leukemia (ALL) patients receiving different treatment options.

Methods

We analyzed data from the United States SEER-Medicare database (2007–2015) for patients ≥65 years diagnosed with ALL. Data were stratified by treatment options into three groups as chemotherapy: the use of antimetabolites, anthracyclines, alkylating agents or vinca alkaloids; other treatment: the use of corticosteroids/tyrosine kinase inhibitors without chemotherapy; and no treatment. Logistic regression was used to examine risk factors for VTE and Cox proportional regression was used to evaluate Hazard Ratios (HRs) for the effect of VTE on mortality in ALL patients.

Results

In a cohort of 1088 elderly ALL patients, 17.4 % patients had a diagnosis of VTE. VTE was diagnosed in 27.7 % of 159 patients who received chemotherapy, 16.2 % of 328 patients who received other treatment, and 15.3 % of 601 patients who did not receive any treatment (p < 0.001). Adjusted odds of VTE were 1.59 (95 % CI, 1.02–2.48) in patients who received chemotherapy, and OR_a = 0.88 (95 % CI, 0.60–1.30) in those who received other treatment, compared to those who did not receive any treatment. VTE was not associated with the risk of death in ALL patients (HR_a = 0.85, 95 % CI, 0.70–1.02).