Risk factors and mortality associated with venous thromboembolism in the elderly US population with acute lymphocytic leukemia

Abstract

Objective: The purpose of our study was to examine risk factors for venous thromboembolism (VTE) and VTE associated mortality in elderly acute lymphocytic leukemia (ALL) patients receiving different treatment options. Methods: We analyzed data from the United States SEER-Medicare database (2007–2015) for patients ≥65 years diagnosed with ALL. Data were stratified by treatment options into three groups as chemotherapy: the use of antimetabolites, anthracyclines, alkylating agents or vinca alkaloids; other treatment: the use of corticosteroids/tyrosine kinase inhibitors without chemotherapy; and no treatment. Logistic regression was used to examine risk factors for VTE and Cox proportional regression was used to evaluate Hazard Ratios (HRs) for the effect of VTE on mortality in ALL patients. Results: In a cohort of 1088 elderly ALL patients, 17.4 % patients had a diagnosis of VTE. VTE was diagnosed in 27.7 % of 159 patients who received chemotherapy, 16.2 % of 328 patients who received other treatment, and 15.3 % of 601 patients who did not receive any treatment (p < 0.001). Adjusted odds of VTE were 1.59 (95 % CI, 1.02–2.48) in patients who received chemotherapy, and ORa = 0.88 (95 % CI, 0.60–1.30) in those who received other treatment, compared to those who did not receive any treatment. VTE was not associated with the risk of death in ALL patients (HRa = 0.85, 95 % CI, 0.70–1.02). Conclusion: Our study identified VTE risk factors and the effect of VTE on mortality in elderly ALL patients with and without treatment.

Keywords

• Acute Lymphocytic Leukemia (ALL)
• Chemotherapy
• Deep Vein Thrombosis (DVT)
• Pulmonary Embolism (PE)
• Venous Thromboembolism (VTE)