Key result
Infection was significantly associated with an increased risk of venous thromboembolism in adolescent and young adult oncology patients (OR 6.35; 95% CI 2.30-17.55; p<0.0001).
Why the study?
Venous thromboembolism incidence, risk factors, and outcomes have been understudied in adolescent and young adult oncology patients who possess unique biological and physiological characteristics.
What are the risk factors and outcomes associated with venous thromboembolism in adolescent and young adult oncology patients?
Case-Control (n=105)
No
What are the risk factors and outcomes associated with venous thromboembolism in adolescent and young adult oncology patients?
In adolescent and young adult oncology patients, having leukemia/lymphoma, multiple central venous catheters, or infections significantly increases the risk of venous thromboembolism, which is associated with higher relapse and mortality rates.
Supports incorporating infection into VTE risk assessment for AYA oncology patients; leaves open whether prophylaxis alters outcomes.
BACKGROUND: Venous thromboembolism (VTE) is a known complication among pediatric and adult cancer patients. Adolescent and young adult oncology (AYAO) patients have unique biological and physiological characteristics that make them distinct from other populations. Our objective was to study the VTE incidence, risk factors, and outcomes, which have been understudied in this population. PROCEDURE: A retrospective case-control study was conducted on AYAO participants with new or relapsed cancer and an imaging confirmed VTE from January 2011 to November 2016 at our institution. Eligible AYAO participants without a history of VTE were designated as controls and were randomly selected from our institution's tumor registry. Demographics, medical history, surgeries, central venous catheter (CVC) data, VTE diagnosis and treatment, relapses, and deaths were abstracted. RESULTS: Thirty-five VTE cases and 70 controls were included in this analysis. Eighty percent of cases had leukemia or lymphoma (vs. a solid tumor) compared to 58% of controls. The majority of VTEs (57%) were CVC associated, and more than 70% of cases had more than one CVC placed during their cancer treatment versus 34% of controls. Infection was associated with increased VTE risk (OR = 6.35, 95% CI = 2.30, 17.55, p < .0001). VTE cases had increased cancer relapse (23% vs. 10%) and mortality rates (29% vs. 16%) than controls. CONCLUSION: AYAO participants with a VTE were more likely to have leukemia or lymphoma, more than one CVC or infection. Further studies are needed to identify patients who would benefit from modifiable prevention measures, such as limiting to one CVC, preventing infections, or considering prophylactic anticoagulation for those with a liquid tumor.
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Hsiao et al. (2021) conducted a case-control in Cancer (Adolescent and young adult oncology) (n=105). Infection vs. No infection was evaluated on Venous thromboembolism (VTE) (OR 6.35, 95% CI 2.30-17.55, p=<0.0001). Infection was significantly associated with an increased risk of venous thromboembolism in adolescent and young adult oncology patients (OR 6.35; 95% CI 2.30-17.55; p<0.0001).
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