Thrombodynamics test efficacy in predicting thromboembolic complications in patients with lymphoproliferative disorders

Abstract

Background. Patients with lymphoproliferative disorders (LPD) are at increased risk of developing venous thromboembolic complications (VTEC). Existing risk assessment systems for VTEC (Khorana, Vienna, ThroLy, etc.) do not have sufficient prognostic accuracy in this patient population. The thrombodynamics test may improve the prognosis of VTEC and optimize the prophylactic use of anticoagulants in these patients.Aim. To evaluate thrombodynamics test efficacy in assessing the risk of venous VTEC in LPD patients.Materials and methods. Medical data of 990 patients with LPD who received treatment at the Kirov Research Institute of Hematology and Blood Transfusion from 2019 to 2021 were analyzed. Coagulation parameters were evaluated at admission, as well as the risk of developing VTEC by prognostic scales Khorana, Vienna, ThroLy, SAVED, and Padua. Data are presented as median and interquartile range. Mann–Whitney U test was used to compare two independent groups. Correlation was determined using Spearman’s rank correlation. Logistic regression was used to determine dependencies. The diagnostic value of laboratory tests was established through ROC analysis.Results. In the overall cohort of LPD patients, the incidence of VTEC was 2.1 %. Screening coagulogram parameters in these patients did not exceed reference values. Patients with LPD who developed VTEC initially showed a significant increase in clot velocity (V), initial growth velocity (Vi), and clot size (Cs). It was found that the presence of spontaneous clots significantly increased the chances of developing a thrombotic event (odds ratio 3.99; 95 % confidence interval 1.56–10.22; p = 0.004). It was also determined that V velocity is an independent predictor of VTEC (adjusted odds ratio 1.053; 95 % confidence interval 1.016–1.090; p = 0.0046). The AUC determined by ROC analysis for the V parameter was 0.722 (threshold value 30.7 μm/min sensitivity 81 %, specificity 57.4 %).Conclusion. Clot growth velocity is the most informative parameter of thrombodynamics test in predicting VTEC.

Keywords

• lymphoproliferative disorder
• venous thromboembolic complication
• thrombodynamics