PB0909 - Microparticles and D-Dimers improve prediction of chemotherapy- associated thrombosis in cancer patients

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Mohamed CHEKKAL, Doctorate in medical sciences

Head of department
Medicine faculty. Oran1 university. Oran university establishment (EHU). Oran. Algeria.
Oran, Oran, Algeria

Co-Author(s)

NY

Nabil YAFOUR

Head of department
Department of hematology. EHU Oran. Medicine faculty. Oran1 unversity
Oran, Oran, Algeria
ME

Mohamed ELHORRI

Head of unit
HMRUO
Oran, Oran, Algeria
AS

Amel Soulef SAADI OUSLIM

head of department
Department of biochemestery. EHU Oran. Medicine faculty. Oran1 unversity
Oran, Oran, Algeria
AA

Affaf ADDA

Head of unit
Department of hemobiology and blood transfusion. EHU Oran. Medicine faculty.Oran1 university. Oran. Algeria
Oran, Oran, Algeria
NZ

Noujoum ZMOULI

Head of unit
Department of hemobiology and blood transfusion. EHU Oran. Medicine faculty.Oran1 university. Oran. Algeria
Oran, Oran, Algeria
MB

Mohamed Nazim Bennaoum

Head of unit
Department of hemobiology and blood transfusion. EHU Oran. Medicine faculty.Oran1 university. Oran. Algeria
Oran, Oran, Algeria

Background: The cancer is associated to a state of hypercoagulability which can be the cause of venous thromboembolism (VTE) representing an undeniable cause of morbidity and mortality. Nevertheless, the pathophysiology of thrombi formation has not yet been fully elucidated and large variations of the risk have been demonstrated related to cancer characteristics, to the patient itself or to treatment.

Aims: In order to predict the risk of VTE in our patients, we conducted a prospective cohort study in cancer patients who will receive chemotherapy.

Methods: First, we evaluated the risk of cancer-related VTE by hypercoagulability parameters (D-dimers, microparticles, V Leiden mutation).
In a second step, we tested the predictive value of the Khorana risk score (KRS) of cancer- related VTE. Then, we developed and tested the predictive value of an expanded score based on the addition of predictive biomarkers to the KRS parameters.

Results: 165 patients were included in our study. After an observation period of 2 years, 10 patients (6.0%) developed a VTE. Among the criteria studied, only the D-dimers and the microparticles were predictive of VTE in cancer.
We validated the Khorana risk score in our study population. The positive predictive value (VPP) of this score was 13,6% and the negative predictive value (VPN) was 97,9%. After adding 2 predictive biomarkers (D-dimers and microparticles), the expanded score had a PPV of 23,5% and a VPN of 98,6%. An increased score ≥to the cut-off value of 4 set by a ROC curve was associated with a higher risk of VTE (HR = 8.753, 95% CI [2.348-32.629]).

Conclusion(s): The addition of biomarkers to the routine clinical and biological parameters of the Khorana score enhances the predictive potential of VTE risk in cancer. This will allow a better stratification of patients according to the risk of VTE with the aim of optimizing thromboprophylaxis.