Risk factors of venous thromboembolic events among diffuse large B-cell lymphoma patients receiving first-line treatment

Abstract Venous thromboembolic events (VTEs) remain a major cause of mortality and morbidity among lymphoma patients. In this retrospective study, we analyzed the risk factors for VTEs in DLBCL (diffuse large B-cell lymphoma) patients treated with first-line (1L) chemoimmunotherapy in Kuopio and Oulu University Hospitals (2010–2019).VTE occurred in 17.2% (n = 59) in the whole population, and seven VTEs occurred during anticoagulant therapy. Statistically significant risk factors for VTE included age > 65 years, ECOG (Eastern Cooperative Oncology Group) > 1, thrombophilia, bulky disease, LDH > ULN (lactate dehydrogenase; upper limit of normal) and IPI (International Prognostic Index) 4–5. In a multivariate Cox regression model, history of thrombophilia and bulky disease were independent risk factors for VTE (p = 0.000 and p = 0.032, respectively). VTE at 1L had no significant effect on survival at 2 or 5 years of follow-up. Two different VTE risk scores were tested in DLBCL patients treated in 1L. A risk score 2 (age > 65/LDH > ULN/ ECOG > 1/thrombophilia = 1 p., bulky disease 2 p.) received a higher ROC value (0.680) than risk score 1. In the “high risk” group (5 p., according to risk score 2), VTE risk was increased, at 35.3%.