Risk Assessment for Venous Thrombosis in Lymphoma and Emerging Biomarkers

Venous Thrombosis is a frequent and clinically significant complication in lymphoma patients, resulting in increased morbidity, mortality and therapeutic challenges. The pathophysiological mechanisms underlying lymphoma-associated thrombosis are multifactorial, involving patients’ clinical characteristics, tumour biology, systemic inflammation, endothelial dysfunction and therapy-induced prothrombotic changes. Traditional predictive tools for cancer-associated thrombosis (CAT) have shown suboptimal application in lymphoma patients due to disease-specific heterogeneity. The ThroLy score was developed as a lymphoma-specific model incorporating parameters such as extranodal involvement, mediastinal disease, performance status, a prior venous thromboembolic event, and specific laboratory values. While it shows improved predictive value compared with general CAT models, its accuracy remains limited, particularly across different lymphoma subtypes and treatment regimens. Research in the field has therefore focused on evaluating emerging biomarkers—D-dimer, microparticles and inflammatory cytokines—as risk assessment tools. Integrative approaches that combine clinical variables with such biomarkers may yield a more dynamic and individualised risk-prediction model to guide thromboprophylactic strategies. The present review summarises current knowledge on thrombotic risk assessment across lymphoma subtypes and highlights the potential role of novel biomarkers in developing a more precise approach to thrombosis prevention and management. Importantly, it provides a comprehensive overview of currently available literature, highlighting the need for personalised thrombosis risk stratification strategies in lymphoma.