title: Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients.
abstract: Lymphoma patients are at increased risk of thromboembolic events but thromboprophylaxis in these patients is largely underused. We sought to develop and validate a simple model, based on individual clinical and laboratory patient characteristics that would designate lymphoma patients at risk for thromboembolic event. The study population included 1,820 lymphoma patients who were treated in the Lymphoma Departments at the Clinics of Hematology, Clinical Center of Serbia and Clinical Center Kragujevac. The model was developed using data from a derivation cohort (n = 1,236), and further assessed in the validation cohort (n = 584). Sixty-five patients (5.3%) in the derivation cohort and 34 (5.8%) patients in the validation cohort developed thromboembolic events. The variables independently associated with risk for thromboembolism were: previous venous and/or arterial events, mediastinal involvement, BMI>30 kg/m(2) , reduced mobility, extranodal localization, development of neutropenia and hemoglobin level < 100g/L. Based on the risk model score, the population was divided into the following risk categories: low (score 0-1), intermediate (score 2-3), and high (score >3). For patients classified at risk (intermediate and high-risk scores), the model produced negative predictive value of 98.5%, positive predictive value of 25.1%, sensitivity of 75.4%, and specificity of 87.5%. A high-risk score had positive predictive value of 65.2%. The diagnostic performance measures retained similar values in the validation cohort. Developed prognostic Thrombosis Lymphoma - ThroLy score is more specific for lymphoma patients than any other available score targeting thrombosis in cancer patients. Am. J. Hematol. 91:1014-1019, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade. darko.antic1510976@gmail.com.|Medical Faculty, Department for internal medicine, University of Belgrade, Belgrade. darko.antic1510976@gmail.com.
authors.forename: Darko
authors.initials: D
authors.lastname: Antic
authors.affiliation: Department for Medical Statistics and Informatics, Medical Faculty, University of Belgrade, Belgrade.|Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Natasa
authors.initials: N
authors.lastname: Milic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Nikolovski
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.|Medical Faculty, Department for internal medicine, University of Belgrade, Belgrade.
authors.forename: Milena
authors.initials: M
authors.lastname: Todorovic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.|Medical Faculty, Department for internal medicine, University of Belgrade, Belgrade.
authors.forename: Jelena
authors.initials: J
authors.lastname: Bila
authors.affiliation: Clinic for Hematology, Clinical Centre Kragujevac, Kragujevac.|Medical Faculty, Department for internal medicine, University of Kragujevac, Kragujevac.
authors.forename: Predrag
authors.initials: P
authors.lastname: Djurdjevic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.|Medical Faculty, Department for internal medicine, University of Belgrade, Belgrade.
authors.forename: Bosko
authors.initials: B
authors.lastname: Andjelic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.
authors.forename: Vladislava
authors.initials: V
authors.lastname: Djurasinovic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sretenovic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.
authors.forename: Vojin
authors.initials: V
authors.lastname: Vukovic
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.
authors.forename: Jelena
authors.initials: J
authors.lastname: Jelicic
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hayman
authors.affiliation: Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.|Medical Faculty, Department for internal medicine, University of Belgrade, Belgrade.
authors.forename: Biljana
authors.initials: B
authors.lastname: Mihaljevic
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*