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. 2023 Sep 12;7(17):4721-4727.
doi: 10.1182/bloodadvances.2022008644.

The prevalence of thrombocytopenia in patients with acute cancer-associated thrombosis

Charles Hsu  1 , Rushad Patell  2   3 , Jeffrey I Zwicker  2   3
Affiliations

The prevalence of thrombocytopenia in patients with acute cancer-associated thrombosis

Charles Hsu et al. Blood Adv. .

Abstract

Venous thromboembolism (VTE) and thrombocytopenia are frequently encountered complications in patients with cancer. Although there are several studies evaluating the safety and efficacy of anticoagulation regimens in patients with cancer-associated thrombosis (CAT) with thrombocytopenia, there is a paucity of data assessing the scope of the concurrent diagnoses. This study evaluates the prevalence of thrombocytopenia among patients with acute CAT. A retrospective cohort analysis of adult patients with cancer was conducted at Beth Israel Deaconess Medical Center between 2010 and 2021 with CAT (acute VTE within 6 months after new diagnosis of malignancy). VTE included acute deep vein thrombosis, pulmonary embolism, abdominal or intrathoracic venous thrombosis, and cerebral sinus thrombosis. The lowest platelet count within 2 weeks of (before or after) the index VTE event was identified to assess the frequency and grade of concurrent thrombocytopenia. We identified 3635 patients with CAT (80% solid tumors, 18% hematologic malignancies, and 2% multiple concurrent cancer diagnoses). Thrombocytopenia (defined as platelet count <100 000/μL) occurred in 22% (95% CI 21%-24%) of patients with CAT with solid tumors diagnoses and 47% (95% CI 43%-51%) of patients with CAT and hematologic malignancies. Severe thrombocytopenia (platelet count <50 000/μL) occurred in 7% (95% CI 6%-8%) of patients with solid tumors and 30% (95% CI 27%-34%) of patients with hematologic malignancies. Concurrent diagnoses of CAT and thrombocytopenia are very common, especially among patients with hematologic malignancies.

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Conflict of interest statement

Conflict-of-interest disclosure: C.H. has received consulting fees from Anthos Therapeutics and was previously employed at Baxter/Baxalta. J.I.Z. received research funding from Incyte and Quercegen; provided consultancy services to Sanofi, CSL, and Parexel; and reports honoraria from/advisory board participation with Pfizer/Bristol Myers Squibb, Portola, and Daiichi. R.P. declares no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Cohort construction. Selection process of appropriate index CAT events.
Figure 2.
Figure 2.
Trends in cancer-associated thrombosis and thrombocytopenia. (A) Trend in CAT by cancer type over time in absolute number of events, top, and as proportion of total events, bottom. (B) Trend in CAT-associated thrombocytopenia by severity over time in absolute number of events, top, and as proportion of total events, bottom. Gyn, gynecologic; Plt, platelet count.
See this image and copyright information in PMC

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