Analysis Of Clinical Characteristics In 82 Patients Of Hematologic Malignancies With Venous Thromboembolism

Objective To analyze and summarize the clinical features of 82 patients of hematologic malignancies(HM)with newly diagnosed venous thromboembolism(VTE),which can comprehend the incidence of HM-related VTE and its risk factors to provide references for early diagnosis and treatment.Methods The case group clinical data is collected on January 2012 to December 2020 from HM with newly diagnosed VTE in the General Hospital of Ningxia Medical University,and100 patients of HM without VTE as control group at the same time.The data recorded age,gender,smoking status,underlying diseases,hematological malignancies types,VTE location and time of occurrence,clinical symptoms,chemotherapy regimens,anticoagulation therapy,survival time after treatment,etc.Retrospective analysis was conducted to investigate the clinical characteristics,risk factors,anticoagulation therapy and survival after treatment of HM patients with VTE.Finally,we explored the predictive value of peripheral blood WBC,D-dimer of VTE in HM patients.Results A total of 82 cases of HM with VTE,including 57 cases of acute leukemia(69.5%,57/82),13 cases of lymphoma(15.9%,13/82),10 cases of multiple myeloma(12.2%,10/82),one case of chronic myeloid leukemia(1.2%,1/82),one case of myeloproliferative tumor(1.2%,1/82).14 cases(17.0%,14/82)with purely pulmonary embolism(PE),16 cases(19.5%,16/82)with PE and deep vein thrombosis(DVT)or catheter-related thrombosis(CRT),and 14 cases with purely DVT(17.0%,14/82),38 cases of CRT(46.3%,38/82).PE occurred in 15 cases(50%,15/30)in both lobes,6 cases in unilateral left lobe(20%,6/30),and 9 cases in unilateral right lobe(30%,9/30).DVT most occurred in the left lower limb accounted for 30.8%(8/26),CRT most occurred in the right upper limb accounted for 89.5%(34/38).VTE occurred in 52 cases(63.4%,52/82)within the first month after the diagnosis of HM.Univariate regression analysis showed that chemotherapy,bed rest,pulmonary infection,intravenous catheterization,and previous surgical history were the main risk factors for HM patients with VTE,multivariate regression analysis showed that bed rest and intravenous catheterization were two independent risk factors of HM with VTE patients.Among the 82 inpatients,53 patients received anticoagulation therapy(64.6%,53/82),29 patients were not treated with anticoagulation(35.4%,29/82),and the anticoagulation group(median survival time 28 months 95% CI 15.5-40.5),no anticoagulation group(median survival time 7.5months 95% CI 0.0-14.5).Conclusion Hematologic malignancies(AL,ML,MM,CML,MPN)patients can be complicated with VTE,which usually occurs within 3 months after the diagnosis of HM and it is more common in middle-aged and elderly patients.The most common is catheter-related thrombosis(CRT),which is most in the right upper limb,the next is PE and DVT,PE occurs mostly in both lungs,DVT is most in the left lower limb.The overall incidence was 4.0%.HM patients with VTE is associated with a variety of risk factors,which suggest hematologists should pay more attention to the risk assessment and stratification of HM patients.Taking necessary prevention strategies and strengthen management to reduce the occurrence of VTE,and individualized anticoagulation to improve the survival rate and prognosis of patients.