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. 2018 Mar 1:16:2.
doi: 10.1186/s12959-018-0161-9. eCollection 2018.

Thromboembolic events in cancer patients on active treatment with cisplatin-based chemotherapy: another look!

Hikmat Abdel-Razeq  1 , Asem Mansour  2 , Hazem Abdulelah  1 , Anas Al-Shwayat  1 , Mohammad Makoseh  1 , Mohammad Ibrahim  1 , Mahmoud Abunasser  1 , Dalia Rimawi  3 , Abeer Al-Rabaiah  4 , Rozan Alfar  1 , Alaa' Abufara  1 , Alaa Ibrahim  2 , Anas Bawaliz  1 , Yousef Ismael  5
Affiliations

Thromboembolic events in cancer patients on active treatment with cisplatin-based chemotherapy: another look!

Hikmat Abdel-Razeq et al. Thromb J. .

Abstract

Background: The risk of thromboembolic events is higher among cancer patients, especially in patients undergoing chemotherapy. Cisplatin-based regimens claim to be associated with a very high thromboembolic rate. In this study, we report on our own experience with thrombosis among patients on active cisplatin-based chemotherapy.

Methods: Medical records and hospital databases were searched for all the patients treated with any cisplatin-based regimen for any kind of cancer. Thrombosis was considered cisplatin-related if diagnosed any time after the first dose and up to 4 weeks after the last. The Khorana risk assessment model was performed in all cases.

Results: A total of 1677 patients (65.5% males, median age: 50 years) treated with cisplatin-based regimens were identified. Head and neck (22.9%), lung (22.2%), lymphoma and gastric (11.4% each) were the most common primary tumors. Thromboembolic events were reported in 110 (6.6%); the highest was in patients with gastric cancer (20.9%) and the lowest in patients with head and neck cancers (2.3%) and lymphoma (1.6%). Thrombosis included deep vein thrombosis (DVT) in 69 (62.7%), pulmonary embolism (PE) in 18 (16.9%) and arterial thrombosis in 17 (15.6%). A majority (51.1%) of the patients had stage IV disease and only 16% had stage I or II.In a multivariate analysis, significantly higher rates of thrombosis were associated with gastric as the primary tumor, advanced-stage disease, female sex but not age, and the Khorana risk score or type of cisplatin regimen. While the presence of CVC was significantly associated with the risk of thrombosis (p < 0.0001) in the univariate analysis, and such significance was lost in the multivariate analysis (odds ratio, 1.098; 95%CI, 0.603-1.999, p = 0.7599).

Conclusions: Thromboembolic events in cancer patients on active cisplatin-based chemotherapy were commonly encountered. Gastric cancer, regardless of other clinical variables, was associated with the highest risk.

Keywords: Cancer; Chemotherapy; Cisplatin; Thrombosis.

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Conflict of interest statement

The study was approved by our Institutional Review Board and consent was waived.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Timp JF, Braekkan SK, Versteeg HH, Cannegieter SC. Epidemiology of cancer-associated venous thrombosis. Blood. 2013;122(10):1712–1723. doi: 10.1182/blood-2013-04-460121. - DOI - PubMed
    1. Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients. Cancer. 2007;110(10):2339–2346. doi: 10.1002/cncr.23062. - DOI - PubMed
    1. Falanga A, Marchetti M, Vignoli A. Coagulation and cancer: biological and clinical aspects. J Thromb Haemost. 2013;11(2):223–233. doi: 10.1111/jth.12075. - DOI - PubMed
    1. Khorana AA. Risk assessment and prophylaxis for VTE in cancer patients. J Natl Compr Cancer Netw. 2011;9(7):789–797. doi: 10.6004/jnccn.2011.0064. - DOI - PubMed
    1. Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007;5:632–634. doi: 10.1111/j.1538-7836.2007.02374.x. - DOI - PubMed

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