Monocyte count associated with subsequent symptomatic venous thromboembolism (VTE) in hospitalized patients with solid tumors.
BACKGROUND
Solid tumor is the strongest risk factor for VTE in Thai medical in-patients. This study aimed to identify the markers predicting symptomatic VTE in this group.


METHODS
Solid tumor patients admitted to the medical wards from June 2007 to December 2009 were monitored for VTE symptoms, excluding patients with VTE on admission. Anticoagulant prophylaxis was not given. Cases were all symptomatic VTE within 6 weeks after discharge. The controls were active solid tumor in-patients admitted in 2009 and did not develop VTE. The cases and controls were compared for the risk factors of VTE and complete blood count (CBC) on admission.


RESULTS
There were 28 radiology-confirmed VTE cases during the 2.5-year study period. There were 280 solid tumor patients without VTE as the controls. There was no difference in age (58.4 vs. 61.6 years), sex (53.6% vs. 64.3% male), presence of leg paralysis, acute infection and obesity between cases and controls, respectively. The cases showed higher absolute monocyte counts compared with the controls (0.76 vs. 0.56×10(9)/L, p 0.013), but there were no differences in other CBC parameters. In a multivariate analysis, cancer of unknown primary (Odds ratio [OR] 13.7, 95% confidence interval [CI] 2.74-68.7, p 0.001), biliary cancer (OR 6.6, 95% CI 1.80-24.3, p 0.004) and a monocyte count over 0.5×10(9)/L (OR 5.0, 95% CI 1.62-15.5, p 0.005) significantly associated with VTE.


CONCLUSIONS
Metastatic diseases with obscured primary sites, biliary carcinomas and higher monocyte counts on admission are related to subsequent VTE in hospitalized cancer patients.
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. rojnuckarinp@gmail.com
Ponlapat
P
Rojnuckarin
Noppacharn
N
Uaprasert
Virote
V
Sriuranpong
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D006760:Hospitalization; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009369:Neoplasms / Q000097:blood* / Q000473:pathology*; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood* / Q000473:pathology*; D055815:Young Adult
D014408:Biomarkers, Tumor