title: Biomarkers predictive of venous thromboembolism in patients with newly diagnosed high-grade gliomas.
abstract: BACKGROUND
  High-grade gliomas (HGGs) are among the most prothrombotic of malignancies.
  
  
  METHODS
  We performed a prospective study to investigate 11 potential biomarkers for prediction of venous thromboembolism (VTE) in newly diagnosed HGG patients who had undergone a neurosurgical intervention. In addition, we tested 2 VTE risk assessment models (RAMs). The strongest predictors of VTE, which were identified by statistical forward selection, were used for the first RAM. The parameters used for the second RAM were both predictive of VTE and available in routine clinical practice.
  
  
  RESULTS
  One hundred forty-one HGG patients were included in this study, and 24 (17%) of them developed VTE during follow-up. An association with the risk of future VTE was found for the following parameters: leukocyte count, platelet count, sP-selectin, prothrombin-fragment 1 + 2, FVIII activity, and D-dimer. The first RAM included low platelet count (<25th percentile of the study population) and elevated sP-selectin (≥75th percentile). The cumulative VTE probability after 12 months was 9.7% for score 0 (n = 76), 18.9% for score 1 (n = 59), and 83.3% for score 2 (n = 6). The second RAM included low platelet count (<25th percentile), elevated leukocyte count, and elevated D-dimer (≥75th percentile). The probability of VTE was 3.3% for score 0 (n = 63), 23.0% for score 1 (n = 53), and 37.7% for score 2 (n = 22) or score 3 (n = 3).
  
  
  CONCLUSIONS
  We identified biomarkers suitable for assessing the VTE risk in newly diagnosed HGG patients. The application of 2 RAMs allowed identification of patients at high risk of developing VTE. We could also define patients at low risk of VTE, who would most probably not benefit from extended primary thromboprophylaxis.
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Johannes
authors.initials: J
authors.lastname: Thaler
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Cihan
authors.initials: C
authors.lastname: Ay
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kaider
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Reitter
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Johanna
authors.initials: J
authors.lastname: Haselböck
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Christine
authors.initials: C
authors.lastname: Mannhalter
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Christoph
authors.initials: C
authors.lastname: Zielinski
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria (J.T., C.A., E-M.R., J.H., I.P.); Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna General Hospital, Vienna, Austria (J.T., C.A., E-M.R., C.Z., C.MAR., J.H., I.P.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.MAN.); Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria (C.Z., C.MAR.); Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria (A.K.).
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D016543:Central Nervous System Neoplasms / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000097:blood / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000032:analysis*; D010976:Platelet Count; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000150:complications / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D019007:P-Selectin
keywords: biomarkers; high-grade gliomas; prediction; risk assessment models; venous thromboembolism