Lisa Baumann Kreuziger1, Manila Gaddh2, Oluwatomiloba Onadeko3, Gemlyn George4, Tzu-Fei Wang5, Thein H Oo6, Michael Jaglal7, Damon E Houghton8, Michael B Streiff9, Radhika Gali10, Mingen Feng11, Pippa Simpson11, Henny H Billett12. 1. Blood Research Institute, Versiti, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: lisakreuziger@versiti.org. 2. Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA. 3. Emory University, Atlanta, GA, USA. 4. Medical College of Wisconsin, Department of Medicine/Hematology and Oncology, Milwaukee, WI, USA. 5. Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA. 6. University of Texas MD Anderson Cancer Center, Houston, TX, USA. 7. Division of Hematology and Oncology, Department of Hematology and Oncology, Morsani College of Medicine, Moffitt Cancer Center, Tampa, FL, USA. 8. Department of Cardiovascular Diseases, Division of Vascular Medicine & Department of Medicine, Division of Hematology/Oncology, Mayo Clinic, Rochester, MN, USA. 9. Division of Hematology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 10. Albert Einstein College of Medicine, Bronx, NY, USA. 11. Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. 12. Albert Einstein College of Medicine, Bronx, NY, USA; Montefiore Medical Center, New York City, NY, USA.
Abstract
INTRODUCTION: Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy. METHODS: We performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created. RESULTS AND CONCLUSIONS: Of the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999-1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24-5.07)] and death [4.96 (2.47-9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22-45.38)] and death after VTE recurrence [27.29 (3.13-238.13)]. In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE.
INTRODUCTION: Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy. METHODS: We performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created. RESULTS AND CONCLUSIONS: Of the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999-1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24-5.07)] and death [4.96 (2.47-9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22-45.38)] and death after VTE recurrence [27.29 (3.13-238.13)]. In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE.
Authors: Angelo Porfidia; Giulia Cammà; Nicola Coletta; Margherita Bigossi; Igor Giarretta; Andrea Lupascu; Giuseppe Scaletta; Enrica Porceddu; Paolo Tondi; Giovanni Scambia; Gabriella Ferrandina; Roberto Pola Journal: Front Cardiovasc Med Date: 2022-06-28
Authors: Anna Falanga; Avi Leader; Chiara Ambaglio; Zsuzsa Bagoly; Giancarlo Castaman; Ismail Elalamy; Ramon Lecumberri; Alexander Niessner; Ingrid Pabinger; Sebastian Szmit; Alice Trinchero; Hugo Ten Cate; Bianca Rocca Journal: Hemasphere Date: 2022-07-13