Blood Journal
Leading the way in experimental and clinical research in hematology

Prediction of venous thromboembolism in cancer patients

  1. Cihan Ay1,
  2. Daniela Dunkler2,
  3. Christine Marosi3,
  4. Alexandru-Laurentiu Chiriac1,
  5. Rainer Vormittag1,
  6. Ralph Simanek1,
  7. Peter Quehenberger4,
  8. Christoph Zielinski3, and
  9. Ingrid Pabinger1
  1. 1Clinical Division of Haematology and Haemostaseology, Department of Medicine I,
  2. 2Core Unit for Medical Statistics and Informatics, Section of Clinical Biometrics,
  3. 3Clinical Division of Oncology, Department of Medicine I, and
  4. 4Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria


The risk of venous thromboembolism (VTE) is increased in cancer patients. To improve prediction of VTE in cancer patients, we performed a prospective and observational cohort study of patients with newly diagnosed cancer or progression of disease after remission. A previously developed risk scoring model for prediction of VTE that included clinical (tumor entity and body mass index) and laboratory (hemoglobin level and thrombocyte and leukocyte count) parameters was expanded by incorporating 2 biomarkers, soluble P-selectin, and D-Dimer. Of 819 patients 61 (7.4%) experienced VTE during a median follow-up of 656 days. The cumulative VTE probability in the original risk model after 6 months was 17.7% in patients with the highest risk score (≥ 3, n = 93), 9.6% in those with score 2 (n = 221), 3.8% in those with score 1 (n = 229), and 1.5% in those with score 0 (n = 276). In the expanded risk model, the cumulative VTE probability after 6 months in patients with the highest score (≥ 5, n = 30) was 35.0% and 10.3% in those with an intermediate score (score 3, n = 130) as opposed to only 1.0% in patients with score 0 (n = 200); the hazard ratio of patients with the highest compared with those with the lowest score was 25.9 (8.0-84.6). Clinical and standard laboratory parameters with addition of biomarkers enable prediction of VTE and allow identification of cancer patients at high or low risk of VTE.

  • Submitted February 12, 2010.
  • Accepted August 17, 2010.
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