Mitrovic Mirjana, Pantic Nikola, Sabljic Nikica, Bukumiric Zoran, Virijevic Marijana, Pravdic Zlatko, Cvetkovic Mirjana, Rajic Jovan, Bodrozic Jelena, Milosevic Violeta, Todorovic-Balint Milena, Vidovic Ana, Suvajdzic-Vukovic Nada, Antic Darko
Clinic of Hematology, Unviersity Clinical Center of Serbia, 2 Koste Todorovica St., 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Cancers (Basel). 2023 Jun 5;15(11):3060. doi: 10.3390/cancers15113060.
Patients with hematological malignancies have an increased risk of arterial thrombotic events (ATEs) after diagnosis, compared to matched controls without cancer. However, data about incidence and risk factors for ATE development in patients with acute myeloid leukemia (AML) are missing.
The objectives of this study were to determine the incidence of ATE in non-promyelocytic-AML patients and to define the potential risk factors for ATE development.
We conducted a retrospective cohort study of adult patients with newly diagnosed AML. The primary outcome was the occurrence of confirmed ATE, defined as myocardial infarction, stroke or critical limb ischemia.
Out of 626 eligible AML patients, 18 (2.9%) patients developed ATE in the median time of 3 (range: 0.23-6) months. Half of these patients died due to ATE complications. Five parameters were predictors of ATE: BMI > 30 ( = 0.000, odds ratio [OR] 20.488, 95% CI: 6.581-63.780), prior history of TE ( = 0.041, OR 4.233, 95% CI: 1.329-13.486), presence of comorbidities ( = 0.027, OR 5.318, 95% CI: 1.212-23.342), presence of cardiovascular comorbidities ( < 0.0001, OR 8.0168, 95% CI: 2.948-21.800) and cytogenetic risk score ( = 0.002, OR 2.113, 95% CI: 1.092-5.007).
Our study showed that patients with AML are at increased risk of ATE. The risk was increased in patients with cardiovascular comorbidities, previous thrombosis, adverse cytogenetic risk as well as BMI > 30.
与无癌症的匹配对照相比，血液系统恶性肿瘤患者在诊断后发生动脉血栓事件（ATEs）的风险增加。然而，关于急性髓系白血病（AML）患者发生ATE的发生率和危险因素的数据尚缺。
本研究的目的是确定非早幼粒细胞性AML患者中ATE的发生率，并确定ATE发生的潜在危险因素。
我们对新诊断的成年AML患者进行了一项回顾性队列研究。主要结局是确诊的ATE的发生，定义为心肌梗死、中风或严重肢体缺血。
在626例符合条件的AML患者中，18例（2.9%）患者在中位时间3个月（范围：0.23 - 6个月）发生了ATE。其中一半患者因ATE并发症死亡。五个参数是ATE的预测因素：BMI > 30（P = 0.000，比值比[OR] 20.488，95%可信区间[CI]：6.581 - 63.780）、既往血栓形成史（P = 0.041，OR 4.233，95% CI：1.329 - 13.486）、合并症的存在（P = 0.027，OR 5.318，95% CI：1.212 - 23.342）、心血管合并症的存在（P < 0.0001，OR 8.0168，95% CI：2.948 - 21.800）和细胞遗传学风险评分（P = 0.002，OR 2.113，95% CI：1.092 - 5.007）。
我们的数据显示AML患者发生ATE的风险增加。心血管合并症、既往血栓形成、不良细胞遗传学风险以及BMI > 30的患者风险增加。
