Incidence and risk factors for developing venous thromboembolism in Japanese with diffuse large b-cell lymphoma

The reported incidence of venous thromboembolism (VTE) in lymphoma patients is 5% to 17% in Western countries. The incidence and risk factors for developing VTE, however, are not well elucidated in Asian lymphoma patients. The incidence and clinical presentations of VTE were retrospectively assessed in 142 patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL) from April 2006 to November 2010 at Keio University Hospital. Clinical data were collected and all episodes of symptomatic VTE confirmed by imaging were included. Patients with primary central nervous system lymphoma or DLBCL transformed from prior low-grade lymphoma were excluded. Fifteen (11%) patients had at least one episode of VTE. Five patients developed VTE before beginning chemotherapy and 8 episodes of VTE occurred during the first three cycles of chemotherapy. By univariate analysis, age 60 or over (odds ratio [OR] 4.81, confidence interval [CI] 1.04-22.20, p=0.04), Eastern Cooperative Oncology Group performance status 2, 3, or 4 (OR 39.90, CI 5.05-315.20, p=0.0005), and International Prognostic Index high or high-intermediate (OR 9.40, CI 1.20-73.69, p=0.03) were identified as risk factors for developing VTE. By multivariate analysis, performance status 2, 3, or 4 remained a significant risk factor for developing VTE (OR 31.14, CI 3.79-255.62, p=0.001). The incidence of VTE in Japanese with DLBCL was comparable with that in the Western population. Patients with DLBCL and poor performance status at diagnosis were at high risk for developing VTE especially early in the course of treatment.