title: High incidence of thromboembolic events in patients treated with cisplatin-based chemotherapy: a large retrospective analysis.
abstract: OBJECTIVE
  This study was designed to determine the incidence of venous and arterial thromboembolic events (TEEs) in patients treated with cisplatin-based chemotherapy and to analyze the prognostic value of patients' baseline and treatment characteristics in predicting TEE occurrence.
  
  
  METHODS
  We performed a large retrospective analysis of all patients treated with cisplatin-based chemotherapy for any type of malignancy at Memorial Sloan-Kettering Cancer Center in 2008. A TEE was cisplatin-associated if it occurred between the time of the first dose of cisplatin and 4 weeks after the last dose.
  
  
  RESULTS
  Among 932 patients, 169 (18.1%) experienced a TEE during treatment or within 4 weeks of the last dose. TEEs included deep vein thrombosis (DVT) alone in 49.7%, pulmonary embolus (PE) alone in 25.4%, DVT plus PE in 13.6%, arterial TEE alone in 8.3%, or DVT plus arterial TEE in 3.0%. TEEs occurred within 100 days of initiation of treatment in 88% of patients. By univariate analysis, sex, age, race, Karnofsky performance status (KPS), exposure to erythropoiesis-stimulating agents, presence of central venous catheter (CVC), site of cancer, stage of cancer, leukocyte and hemoglobin levels, and Khorana score were all identified as risk factors. However, by multivariate analysis, only age, KPS, presence of CVC, and Khorana score retained significance.
  
  
  CONCLUSIONS
  This large retrospective analysis confirms the unacceptable incidence of TEEs in patients receiving cisplatin-based chemotherapy. In view of the controversy associated with prophylactic anticoagulation in patients with cancer treated with chemotherapy, randomized studies are urgently needed in this specific cancer population treated with cisplatin-based regimens.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room H709, New York, NY 10065, USA.
authors.forename: Russell A
authors.initials: RA
authors.lastname: Moore
authors.forename: Nelly
authors.initials: N
authors.lastname: Adel
authors.forename: Elyn
authors.initials: E
authors.lastname: Riedel
authors.forename: Manisha
authors.initials: M
authors.lastname: Bhutani
authors.forename: Darren R
authors.initials: DR
authors.lastname: Feldman
authors.forename: Nour Elise
authors.initials: NE
authors.lastname: Tabbara
authors.forename: Gerald
authors.initials: G
authors.lastname: Soff
authors.forename: Rekha
authors.initials: R
authors.lastname: Parameswaran
authors.forename: Hani
authors.initials: H
authors.lastname: Hassoun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013923:Thromboembolism / Q000139:chemically induced* / Q000188:drug therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics; D002945:Cisplatin