Sgarabotto D, Prandoni P, Stefani P M, Scano F, Vianello F, Sartori R, Pietrogrande F, Caenazzo A, Girolami A
Second Chair of Internal Medicine, University Hospital of Padua, Italy.
Haematologica. 1998 May;83(5):442-6.
Approximately 15% of patients with cancer will experience a thrombotic episode at some time. Some patients are at particularly high risk depending on the histology of the malignant disease. The aim of the study was to determine the actual prevalence of thrombotic episodes in oncohematologic patients.
We conducted a retrospective cohort analysis on a total of 515 patients that were admitted to the out-patients clinic (Institute of Medical Semeiotics) from January 1, 1986 to January 31, 1996. Two main groups were selected for this study: 133 patients suffering from a myeloproliferative disorder and 382 patients affected by a lymphoproliferative disorder. Follow-up lasted a median of 33 months in both groups (range 3-144 months). The difference between the observed events for each group was estimated by the odds ratio and chi square. Age and sex distribution were estimated by the Mann-Whitney test. Distribution of overall survival was estimated by the Kaplan-Meier method and compared between groups (DVT patients and non DVT patients) by the log-rank test.
Twenty-three patients experienced a venous thrombotic disorder. The prevalence of deep vein thrombosis (DVT) in myeloproliferative and lymphoproliferative disorders was 8.27% (n = 11) and 3.14% (n = 12) respectively (odds ratio = 0.36; 95% CI = 0.14-0.90; chi-square = 4.94 p = 0.028). DVT was apparently idiopathic in 17 cases. In 4 patients another cancer was present; in the remaining 2 patients the thrombotic episode was associated with other predisposing factors. Although 7 of the 23 patients with DVT died, we cannot find any difference in the overall survival compared to oncohematologic patients who did not experience DVT.
The prevalence of symptomatic DVT in the oncohematological patients is lower than reported for solid tumor. Patients affected by myeloproliferative disease have a higher risk of developing thrombosis. DVT if well-treated does not influence the survival of oncohematological patients.
约15%的癌症患者在某些时候会发生血栓事件。根据恶性疾病的组织学类型，一些患者处于特别高的风险中。本研究的目的是确定肿瘤血液学患者血栓事件的实际发生率。
我们对1986年1月1日至1996年1月31日期间门诊（医学符号学研究所）收治的515例患者进行了回顾性队列分析。本研究选取了两个主要组：133例骨髓增殖性疾病患者和382例淋巴增殖性疾病患者。两组的随访时间中位数均为33个月（范围3 - 144个月）。每组观察到的事件差异通过比值比和卡方检验进行估计。年龄和性别分布通过曼 - 惠特尼检验进行估计。总生存分布通过卡普兰 - 迈耶方法进行估计，并通过对数秩检验在组间（深静脉血栓形成患者和非深静脉血栓形成患者）进行比较。
23例患者发生了静脉血栓性疾病。骨髓增殖性疾病和淋巴增殖性疾病中深静脉血栓形成（DVT）的发生率分别为8.27%（n = 11）和3.14%（n = 12）（比值比 = 0.36；95%可信区间 = 0.14 - 0.90；卡方 = 4.94，p = 0.028）。17例DVT显然为特发性。4例患者存在另一种癌症；其余2例患者的血栓事件与其他诱发因素有关。虽然23例DVT患者中有7例死亡，但与未发生DVT的肿瘤血液学患者相比，我们未发现总生存有任何差异。
肿瘤血液学患者中症状性DVT的发生率低于实体瘤的报道。骨髓增殖性疾病患者发生血栓的风险更高。如果得到良好治疗，DVT不会影响肿瘤血液学患者的生存。
