Abstract
The majority of relapsed or refractory lymphoma patients undergo salvage chemotherapy and autologous stem cell transplant (ASCT). Data on venous thromboembolic events (VTEs) in this setting are scarce. This study aims to evaluate the incidence, pattern, and risk factors for VTEs in this group of patients across the continuum of their care. The medical records of adult patients, aged ≥ 18 years, who were diagnosed and treated at our institution from 2007 to 2017 with refractory or relapsed lymphoma and received salvage therapy followed by high-dose chemotherapy and autologous stem cell transplant were retrospectively reviewed. A total of 216 patients, with a median age of 31 (range: 19–60) years, were identified. In total, 36 (16.7%) patients had VTE, mostly in the upper extremity (n=28, 77.8%); 50.0% were related to central venous catheter. Thrombosis rates were higher among patients with high lactate dehydrogenase (LDH) (29.2% <i>vs</i> 5.9%, p< 0.001), mediastinal involvement (25.9% <i>vs</i> 11.5%, p=0.025) and in patients with longer hospital stay (22.1% <i>vs</i> 9.5%, p=0.036). In multivariate analysis, high LDH (OR: 7.66; 95% CI: 2.79–21.04, p<0.001) and mediastinal involvement (OR, 3.64; 95% CI: 1.53–8.70, p=0.002) were associated with significantly higher rates of VTE. In conclusion, patients with relapsed lymphoma undergoing ASCT are at higher risk for VTE, especially those with high LDH and mediastinal involvement. Thromboprophylaxis might be considered in these settings.
Published Version
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