Abstract Details

Title Incidence, risk factors and management of venous thromboembolisms in patients with primary CNS lymphoma

Topic Neuro-oncology

Presentation(s) Neuro-oncology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 011

Objective

To determine incidence, risk factors, management and outcome of VTE in PCNSL patients

Background Venous thromboembolism (VTE) is a known complication of malignancy. While brain tumors in general predispose to VTE, incidence in primary central nervous system lymphoma (PCNSL) is poorly characterized.

Design/Methods Retrospective study of 78 PCNSL patients from 2/1/2002 to 4/1/2020 at the University of Virginia evaluating potential risk factors for development of VTE as well as management and outcome.

Results 24 (31%) of 78 patients developed VTE. Among those, 10 (41.7%) had deep venous thrombosis (DVT) alone, 9 (37.5%) isolated pulmonary embolism (PE) and 5 (20.8%) with both. Median time from PCNSL diagnosis to VTE development was 2 months; 20 of 24 events occurred within the first 6 months. In a univariate competing risks analysis, previous VTE (p < 0.001), impaired ambulation (p = 0.035), baseline hemoglobin < 10 g/dL (p = 0.025) and previous history of diabetes mellitus (p = 0.007) were associated with increased VTE risk. Twenty-three of the 24 patients were anticoagulated acutely with heparin (34.8%) or LMWH (65.2%) and 21 of the 24 chronically with warfarin (28.5%), LMWH (33.3%) or DOAC (38.2%). Median anticoagulant duration was 6.1 months. One adverse event was attributable to anticoagulation (arm hematoma with hemoglobin decrease). Five patients received IVC filters with concomitant oral anticoagulation; one experienced IVC thrombosis after anticoagulation discontinuation. Six of the 24 patients experienced recurrent VTE, four while anticoagulated.

Conclusions

Patients with PCNSL are at high risk of VTE (approximately 30%); most of the risk accrues in the first few months post diagnosis. Patients with past history of VTE, diabetes mellitus, impaired ambulatory status or hemoglobin <10 mg/dL may be at higher risk for this complication. While optimal management is uncertain, there were no concerning safety signals with anticoagulation in our population.

Authors/Disclosures
Miyabi Saito PRESENTER	Miyabi Saito has nothing to disclose.
	No disclosure on file
David Schiff, MD, FAAN (Univ of VA, Division of Neuro Oncology)	Dr. Schiff has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orbus Pharmaceutical. Dr. Schiff has received publishing royalties from a publication relating to health care.

��ɫ��

��ɫ��