文章：

血栓栓塞事件发生与血液系统恶性肿瘤诊断之间的时间关系

Time Relationship between the Occurrence of a Thromboembolic Event and the Diagnosis of Hematological Malignancies

原文发布日期：19 September 2024

DOI: 10.3390/cancers16183196

类型: Article

开放获取: 是

英文摘要：

Objectives. 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. Methods. 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. Results. 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%),p< 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%/p= 0.055), acute lymphocytic leukemia (7 cases/76 patients/9.21%/p= 0.025), and chronic myeloproliferative disease (7 cases/48 patients/14.58%/p= 0.0003). Only the risk of VTE was significantly increased before (OR = 6.79; 95% CI: 1.85–24.95;p= 0.004) and after diagnosis of myeloproliferative disease (OR = 3.12; 95% CI: 1.06–9.16;p= 0.04). Conclusions. 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.

摘要翻译： 

目的。静脉与动脉血栓栓塞（VTE/ATE）常与血液肿瘤诊断并存。本研究旨在评估VTE/ATE诊断与血液肿瘤发生的时间关联性，并进一步探究与血液疾病类型及心脏病史相关的VTE/ATE危险因素。方法。2021年3月至2023年3月（2年间），华沙血液学与输血医学研究所共对1283例患者进行了心脏肿瘤学评估，其中101例（7.8%）确诊VTE/ATE。结果。与VTE相比，ATE在血液恶性肿瘤诊断及治疗前发生的比例显著更高：33/47例（70.2%）对比15/54例（27.8%），p<0.0001。VTE事件在血液肿瘤确诊及启动抗癌治疗后的最初数月内发生风险尤为突出。VTE发生率增高与急性髓系白血病（17例/270例患者/6.30%/p=0.055）、急性淋巴细胞白血病（7例/76例患者/9.21%/p=0.025）及慢性骨髓增殖性疾病（7例/48例患者/14.58%/p=0.0003）显著相关。仅慢性骨髓增殖性疾病患者在确诊前（OR=6.79；95%CI：1.85–24.95；p=0.004）与确诊后（OR=3.12；95%CI：1.06–9.16；p=0.04）的VTE风险均显著升高。结论。在血液肿瘤确诊前，ATE发生率高于VTE。慢性骨髓增殖性疾病患者在其确诊前后均存在异常增高的VTE风险。

原文链接：

Time Relationship between the Occurrence of a Thromboembolic Event and the Diagnosis of Hematological Malignancies