Vu Khanh, Luong Nhiem V, Hubbard Julie, Zalpour Ali, Faderl Stefan, Thomas Deborah A, Yang Daisy, Kantarjian Hagop, Kroll Michael H
Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Med. 2015 Jan;4(1):27-35. doi: 10.1002/cam4.332. Epub 2014 Dec 8.
The purpose was to determine the incidence and prevalence of venous thromboembolism (VTE) in acute leukemia patients from our institution. We conducted a retrospective study on newly diagnosed acute leukemia patients who presented at our institution from November 1999 to May 2005. Descriptive statistics and cross-tabulation were used to describe patient characteristics. Measures of morbidity were used to address VTE risk. Chi-square testing, Fisher's exact testing, Mann-Whitney analyses, or median testing were used to determine between-group differences. Data analyses were conducted using Stata version 11 (Stata Corp., College Station, TX). Two hundred and ninety-nine patients with acute lymphoblastic leukemia (ALL) and 996 patients with acute myeloid leukemia (AML) were included. After excluding patients diagnosed with VTE prior to or at the time of leukemia diagnosis, during the mean time follow-up period of 2.5 years (range: 0.0025-10.3 years), the overall incidence rate of VTE was 3.7 per 100 person-years: 4.2 per 100 person-years for ALL and 3.4 per 100 person-years for AML. Among all patients, the majority (80.6%) developed VTE within 12 months after diagnosis and during thrombocytopenia. The most common VTE was central venous catheter (CVC)-associated upper-extremity deep venous thrombosis. Pulmonary embolism occurred in 15% of ALL patients and 8% of AML patients. VTE recurred in 20.7% of ALL patients and 18.6% of AML patients. VTE occurs frequently in patients with acute leukemia. Studies are needed to identify risk factors for the development and recurrence of VTE among patients with acute leukemia and to establish more effective methods for preventing and treating VTEs in leukemia patients who have thrombocytopenia and/or CVC.
本研究旨在确定我院急性白血病患者静脉血栓栓塞症（VTE）的发病率和患病率。我们对1999年11月至2005年5月期间在我院新诊断的急性白血病患者进行了一项回顾性研究。采用描述性统计和交叉列表来描述患者特征。使用发病率指标来评估VTE风险。采用卡方检验、Fisher精确检验、Mann-Whitney分析或中位数检验来确定组间差异。使用Stata 11版软件（Stata公司，得克萨斯州大学城）进行数据分析。研究纳入了299例急性淋巴细胞白血病（ALL）患者和996例急性髓细胞白血病（AML）患者。排除在白血病诊断之前或诊断时已确诊VTE的患者后，在平均2.5年的随访期内（范围：0.0025 - 10.3年），VTE的总体发病率为每100人年3.7例：ALL为每100人年4.2例，AML为每100人年3.4例。在所有患者中，大多数（80.6%）在诊断后12个月内且血小板减少期间发生VTE。最常见的VTE是中心静脉导管（CVC）相关的上肢深静脉血栓形成。肺栓塞在15%的ALL患者和8%的AML患者中发生。VTE在20.7%的ALL患者和18.6%的AML患者中复发。VTE在急性白血病患者中频繁发生。需要开展研究以确定急性白血病患者发生VTE及其复发的危险因素，并建立更有效的方法来预防和治疗存在血小板减少和/或CVC的白血病患者的VTE。
