title: Venous thromboembolic events in germ cell cancer patients undergoing platinum-based chemotherapy.
abstract: BACKGROUND
  Germ cell tumor (GCT) patients are at risk of venous thromboembolic events (VTEEs). A higher incidence of VTEEs has been reported in GCT patients undergoing cisplatin-based chemotherapy.
  
  
  METHODS
  A retrospective analysis of the incidence of and risk factors for VTEEs in 193 GCT patients receiving platinum-based chemotherapy in Hamburg, Germany, between 2000 and 2009 was performed.
  
  
  RESULTS
  VTEEs occurred in 22 patients (11%). In only 4 patients, the VTEEs occurred during cisplatin-based chemotherapy, while 18 patients (81%) experienced VTEEs prior to initiation of chemotherapy. Pure seminoma, 'intermediate risk' (International Germ Cell Cancer Collaborative Group (IGCCCG)), retroperitoneal or supraclavicular lymph node metastases, elevated lactate dehydrogenase (LDH) levels, a central venous catheter (CVC), arterial hypertension, application of granulocyte colony-stimulating factor (G-CSF) and of ≥ 3 cycles of cisplatin-based chemotherapy could be identified as risk factors. 2 risk groups could be described: (i) VTEEs manifesting before chemotherapy in patients with seminoma, retroperitoneal tumor masses, and elevated LDH levels, and (ii) VTEEs occurring during chemotherapy applied via CVC in patients with supraclavicular lymph node metastases.
  
  
  CONCLUSIONS
  The incidence of VTEEs in GCT patients was 11%, but in the majority of patients, the VTEEs occurred before the initiation of platinum-based chemotherapy. Supraclavicular lymph node metastases and use of a CVC are risk factors for VTEEs during chemotherapy.
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Honecker
authors.forename: Daniel
authors.initials: D
authors.lastname: Koychev
authors.forename: Anna D
authors.initials: AD
authors.lastname: Luhmann
authors.forename: Florian
authors.initials: F
authors.lastname: Langer
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Dieckmann
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: Karin
authors.initials: K
authors.lastname: Oechsle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D054556:Venous Thromboembolism / Q000401:mortality*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin