title: Implications of cytogenetics for venous thromboembolism in acute myeloid leukaemia.
abstract: Due to the high risk of thrombocytopenia and haemorrhage, thrombotic complications have received little attention in patients with acute myeloid leukemia (AML). Furthermore, the predictive role of cytogenetics on venous thromboembolism (VTE) has largely been ignored. This study aimed to evaluate the incidence, risk factors, and prognostic aspects of VTE in AML. A total of 811 consecutive patients with AML were enrolled and analysed retrospectively. Cox time-dependent covariate regression analysis was used to identify the significant predictors of VTE development. To minimise potential confounding factors, we used propensity-score matching to compare overall survival between patients with and without VTE. The six-month and one-year cumulative incidences of VTE were 3.1 % (95 % confidence interval [CI], 2.0-4.7) and 3.9 % (95 % CI, 2.6-5.7), respectively. Of the 26 cases of VTE, 22 (85 %) developed within 6 months of leukemia diagnosis and 13 (50 %) were catheter-related. In multivariate analysis, advanced age (≥ 65 years) (hazard ratio [HR], 2.70; p = 0.03) and increasing cytogenetic risk (common HR, 1.84; p = 0.05) were independent predictors of VTE. There was no significant association between VTE development and decreased survival (p = 0.32 for matched analysis). Advanced age and increasing cytogenetic risk, well-known predictors for clinical outcome in AML, were also independent risk factors of VTE development. Our results suggest that VTE does not hold prognostic implications for AML.
authors.forename: Yun-Gyoo
authors.initials: YG
authors.lastname: Lee
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Ji-hyun
authors.initials: JH
authors.lastname: Kwon
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Yoon
authors.affiliation: Seongyang Park, M D, PhD, Department of Internal Medicine, Division of Hematology and Medical Oncology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea, Tel.: +82 2 2072 3347; Fax: +82 2 762 9662, E-mail: seonpark@snu.ac.kr.
authors.forename: Seongyang
authors.initials: S
authors.lastname: Park
authors.forename: Leo
authors.initials: L
authors.lastname: Song
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Yoon
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Shin
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Min
authors.affiliation: Hee-Je, Kim, MD, PhD, Department of Hematology, Cancer Research Institute, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-070, Korea, Tel.: +82 2 2258 6054; Fax: +82 2 599 3589, E-mail: cumckim@catholic.ac.kr.
authors.forename: Hee-Je
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D020732:Cytogenetic Analysis; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D057216:Propensity Score; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality
keywords: Venous thromboembolism; acute myeloid leukemia; cytogenetics