Kępski Jarosław, Szmit Sebastian, Lech-Marańda Ewa
Department of Cardio-Oncology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland.
Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland.
Cancers (Basel). 2024 Sep 19;16(18):3196. doi: 10.3390/cancers16183196.
Venous and arterial thromboembolism (VTE/ATE) often coexist with onco-hematologic diagnosis. This study aimed to assess the time relationship between the diagnosis of VTE/ATE and blood cancers. The second aim was to identify VTE/ATE risk factors related to the type of hematology disease and cardiac history.
A total of 1283 patients underwent cardio-oncology evaluation at the Institute of Hematology and Transfusion Medicine in Warsaw from March 2021 through March 2023 (2 years), and 101 (7.8%) cases were identified with VTE/ATE.
ATE compared with VTE significantly occurred more often before the diagnosis and treatment of hematologic malignancy: 33/47 (70.2%) vs. 15/54 (27.8%), < 0.0001. The risk of a VTE episode is exceptionally high in the first months after the diagnosis of an onco-hematological disease and the initiation of anticancer treatment. The higher frequency of VTE was associated with acute myeloid leukemia (17 cases/270 patients/6.30%/ = 0.055), acute lymphocytic leukemia (7 cases/76 patients/9.21%/ = 0.025), and chronic myeloproliferative disease (7 cases/48 patients/14.58%/ = 0.0003). Only the risk of VTE was significantly increased before (OR = 6.79; 95% CI: 1.85-24.95; = 0.004) and after diagnosis of myeloproliferative disease (OR = 3.12; 95% CI: 1.06-9.16; = 0.04).
ATEs occur more often than VTE before a diagnosis of blood cancer. The risk of VTE is exceptionally high before and after diagnosis of chronic myeloproliferative disease.
静脉和动脉血栓栓塞（VTE/ATE）常与肿瘤血液学诊断同时存在。本研究旨在评估VTE/ATE诊断与血液系统恶性肿瘤之间的时间关系。第二个目的是确定与血液学疾病类型和心脏病史相关的VTE/ATE危险因素。
2021年3月至2023年3月（2年）期间，共有1283例患者在华沙血液学和输血医学研究所接受了心脏肿瘤学评估，其中101例（7.8%）被诊断为VTE/ATE。
与VTE相比，ATE在血液系统恶性肿瘤诊断和治疗前的发生频率显著更高：33/47（70.2%）对15/54（27.8%），<0.0001。在肿瘤血液学疾病诊断和抗癌治疗开始后的头几个月，VTE发作的风险异常高。VTE的较高发生率与急性髓系白血病（17例/270例患者/6.30%/ = 0.055）、急性淋巴细胞白血病（7例/76例患者/9.21%/ = 0.025）和慢性骨髓增殖性疾病（7例/48例患者/14.58%/ = 0.0003）相关。仅在骨髓增殖性疾病诊断前（OR = 6.79；95% CI：1.85 - 24.95； = 0.004）和诊断后（OR = 3.12；95% CI：1.06 - 9.16； = 0.04）VTE风险显著增加。
在血液系统恶性肿瘤诊断前，ATE的发生比VTE更频繁。慢性骨髓增殖性疾病诊断前后VTE风险异常高。
