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Meta-Analysis
. 2017 Apr 26;7(1):1167.
doi: 10.1038/s41598-017-01307-0.

Leukemia and Risk of Venous Thromboembolism: A Meta-analysis and Systematic Review of 144 Studies Comprising 162,126 Patients

Ying-Ying Wu  1 , Liang Tang  2 , Ming-Huan Wang  3
Affiliations
Meta-Analysis

Leukemia and Risk of Venous Thromboembolism: A Meta-analysis and Systematic Review of 144 Studies Comprising 162,126 Patients

Ying-Ying Wu et al. Sci Rep. .

Abstract

Venous thromboembolism (VTE) has significant clinical implications in leukemia patients. However, the actual frequency of this complication remains unknown. We performed a systematic review and meta-analysis to better estimate the frequency of this complication and to assess the risk factors that contribute to its occurrence. We searched several databases, including PubMed, Embase, and Web of Science, and assessed study quality using the Newcastle-Ottawa scale. The pooled frequency of VTE in leukemia patients was calculated. A total of 144 studies met the eligibility criteria. The incidence rate (IR) of VTE from 72 prospective studies comprising 9,061 patients was 5% (95%CI: 4-6%). The incidence rate (IR) of VTE in ALL, CLL, total-AML, and CML population was 5% (95%CI: 4-6%), 3% (95%CI: 2-5%), 6% (95%CI: 4-8%) and 13% (95%CI: 1-36%). The incidence of VTE was markedly decreased among ALL patients who received anticoagulation treatment (IR: 1%, 95%CI: 0-6%) or concentrates therapy (IR: 3%, 95%CI: 0-9%). The overall incidence of VTE in the leukemia population was high, particularly in transplant recipients, who had the highest risk (IR: 8%, 95% CI: 4-13%). Prophylactic approaches could significantly decrease the occurrence of VTE events.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flowchart of study selection method.
Figure 2
Figure 2
Summary of the categorical meta-analysis. IR = incidence rate. VTE = venous thromboembolism.
Figure 3
Figure 3
Forest plot of the risk of VTE in participants stratified by leukemia subtype. Random effects meta-analysis showing individual and pooled weighted incidence of leukemia-related VTE in studies, stratified by ALL-adult, ALL-child, CLL, AML, APL, and CML. ALL = acute lymphoblastic leukemia. CLL = chronic lymphoblastic leukemia. AML = acute myeloid leukemia. CML = chronic myeloid leukemia. APL = acute promyelocytic leukemia. IR = incidence rate. VTE = venous thromboembolism.
Figure 4
Figure 4
Pooled incidence of venous thromboembolism after receiving prophylaxis. IR = incidence rate. VTE = venous thromboembolism.
Figure 5
Figure 5
Pooled incidence of venous thromboembolism in patients with a catheter. IR = incidence rate. VTE = venous thromboembolism.
Figure 6
Figure 6
Pooled incidence of venous thromboembolism in transplant recipients. IR = incidence rate. VTE = venous thromboembolism.
Figure 7
Figure 7
Pooled incidence of venous thromboembolism subgrouped according to publication year. IR = incidence rate. VTE = venous thromboembolism.
See this image and copyright information in PMC

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