VPB0939 - Impact of Age-adjusted International Prognostic Index for Predicting Venous Thromboembolism in Thai Patients with Diffuse Large B-cell Lymphoma

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Nonthakorn Hantrakun, MD

Instructor
chaing mai University
chiang mai, Chiang Mai, Thailand

Co-Author(s)

PP

Phichayut Phinyo

Staff
Center for Clinical Epidemiology and Clinical Statistic, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Sri Phum, Muang, Chiang Mai, Thailand
AT

Adisak Tantiworawit

associate professor
chaing mai University
chiang mai, Chiang Mai, Thailand
ER

Ekarat Rattarittamrong

associate professor
chaing mai University
chiang mai, Chiang Mai, Thailand
CC

Chatree Chai-Adisaksopha

Hematologist
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Sri Phum, Muang, Chiang Mai, Thailand
TR

Thanawat Rattanathammethee

Instructor
chaing mai University
chiang mai, Chiang Mai, Thailand
SH

Sasinee Hantrakool

Instructor
chaing mai University
chiang mai, Chiang Mai, Thailand
PP

Pokpong Piriyakhuntorn

Instructor
chaing mai University
chiang mai, Chiang Mai, Thailand
TP

Teerachat Punnachet

Instructor
chaing mai University
chiang mai, Chiang Mai, Thailand
PN

Piangrawee Niprapan

Research nurse
chaing mai University
chiang mai, Chiang Mai, Thailand
LN

Lalita Norasetthada

Hematologist
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Sri Phum, Muang, Chiang Mai, Thailand

Background: Lymphoma is among the malignant diseases at high risk for venous thromboembolism (VTE). The international prognostic index (IPI) and age-adjusted IPI (aaIPI) have been used to predict survival outcome for patients with diffuse large B-cell lymphoma (DLBCL).

Aims: This study aimed to determine the VTE incidence and the impact of aaIPI for predicting VTE among Thai patients with DLBCL compared with the Khorana risk score (KRS).

Methods: This was a retrospective cohort study including all adult patients with newly diagnosed pathologically confirmed DLBCL. Patients with VTE were objectively identified by radiologists. Kaplan-Meier method and log-rank test were used to examine the differences in the rate of VTE occurrence in each aaIPI group. We used the area under the receiver operating characteristic (ROC) to quantify the ability of aaIPI to predict VTE.

Results: From 591 newly diagnosed DLBCL patients with median age 58 (range 16-93) years, 32 patients had VTE within the first year of DLBCL diagnosis, given the incidence of VTE of 5.4% (95% confidence interval [CI], 3.7-7.6). VTE patients had more advanced stage (75% vs. 56.3%; P=0.043) and higher LDH (78.1% vs. 54.9%; P=0.010) than non-VTE patients. The 1-year cumulative incidence of VTE was 1.47%, 3.87%, 7.65%, and 8.46% for aaIPI 0 to 3, respectively (P=0.008) (Figure 1A). Patients with aaIPI ≥ 2 had significantly higher 1-year cumulative incidence of VTE than patients with aaIPI < 2 (8.0% vs. 2.8%; hazard ratio, 3.51; 95% CI, 1.57-7.83; P=0.001) (Figure 1B). The area under the ROC for VTE prediction was 0.61, 0.64, 0.65 for KRS, IPI, and aaIPI, respectively.

Conclusion(s): The incidence of VTE among Thai patients with DLBCL was comparable to Caucasians. The aaIPI might be helpful to identify DLBCL patients with a higher risk of VTE especially in patients with aaIPI ≥ 2.