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Open Access 01-12-2024 | Acute Myeloid Leukemia | Research

Venous thromboembolism in patients with acute myeloid leukemia: development of a predictive model

Authors: Mirjana Mitrovic, Nikola Pantic, Zoran Bukumiric, Nikica Sabljic, Marijana Virijevic, Zlatko Pravdic, Mirjana Cvetkovic, Nikola Ilic, Jovan Rajic, Milena Todorovic-Balint, Ana Vidovic, Nada Suvajdzic-Vukovic, Jecko Thachil, Darko Antic

Published in: Thrombosis Journal | Issue 1/2024

Abstract

Background

Patients with acute myeloid leukemia (AML) are at increased risk of venous thromboembolic events (VTE). However, thromboprophylaxis is largely underused.

Objectives

This study aimed to determine possible VTE development risk factors and to develop a novel predictive model.

Methods

We conducted a retrospective cohort study of adult patients with newly diagnosed AML. We used univariate and multivariable logistic regression to estimate binary outcomes and identify potential predictors. Based on our final model, a dynamic nomogram was constructed with the goal of facilitating VTE probability calculation.

Results

Out of 626 eligible patients with AML, 72 (11.5%) developed VTE during 6 months of follow-up. Six parameters were independent predictors: male sex (odds ratio [OR] 1.82, 95% confidence interval [CI]: 1.077–2.065), prior history of thrombotic events (OR 2.27, 95% CI: 1.4–4.96), international normalized ratio (OR 0.21, 95% CI: 0.05–0.95), Eastern Cooperative Oncology Group performance status (OR 0.71, 95% CI: 0.53–0.94), and intensive therapy (OR 2.05, 95% CI: 1.07–3.91). The C statistics for the model was 0.68. The model was adequately calibrated and internally validated. The decision-curve analysis suggested the use of thromboprophylaxis in patients with VTE risks between 8 and 20%.

Conclusion

We developed a novel and convenient tool that may assist clinicians in identifying patients whose VTE risk is high enough to warrant thromboprophylaxis.

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Title: Venous thromboembolism in patients with acute myeloid leukemia: development of a predictive model
Authors: Mirjana Mitrovic
Nikola Pantic
Zoran Bukumiric
Nikica Sabljic
Marijana Virijevic
Zlatko Pravdic
Mirjana Cvetkovic
Nikola Ilic
Jovan Rajic
Milena Todorovic-Balint
Ana Vidovic
Nada Suvajdzic-Vukovic
Jecko Thachil
Darko Antic
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Acute Myeloid Leukemia
Thrombosis
Leukemia
Disseminated Intravascular Coagulation
Published in: Thrombosis Journal / Issue 1/2024
Electronic ISSN: 1477-9560
DOI: https://doi.org/10.1186/s12959-024-00607-6

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