Thrombotic risk assessment in adult patients with lymphoid malignancies in Benin City: A cross sectional study

Abstract

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality in cancer patients. Thromboprophylaxis can be used to prevent VTE in patients with malignany. Risk assessment models (RAM) can be used to identify those who may benefit from thromboprophylaxis. The study aims to determine the cancer associated thrombotic risk of patients with lymphoid malignancies.
Methods: This was a case control study conducted at the Department of Haematology and Blood Transfusion, University of Benin Teaching Hospital, (UBTH) Benin City. Eighty two patients, 18 years and above with lymphoid malignancies and 82 controls were evaluated using the Khorana risk assessment model. Data was analyzed using SPSS version 21.
Results: The ages of patients and controls were 54.0 ±14.0 vs. 50.0±11.0 years, p = 0.06 respectively. They included 41 (50.0%) males in the patient group and 43(52.4%) males in the controls (p =0.76). The commonest types of lymphoid malignancies amongst them were Non-Hodgkin's lymphoma (NHL) 32 ((39.0%), multiple myeloma (MM) 24 (29.3%) and chronic lymphocytic leukaemia/small lymphocytic lymphoma CLL/SLL 18 (21.9%). Patients with lymphoid malignancies had significantly higher risk scores compared to the controls. Majority of the patients have intermediate risk and 3.7% were at high risk of cancer associated thrombosis. Thirteen (15.9%) of the controls had intermediate risk while 69 (84.1%) had low risk. Patients with chronic lymphoid leukaemia/small lymphocytic lymphoma and non-Hodgkin's lymphoma had the high risk status.
Conclusion: Thrombotic risk is largely intermediate in patients with lymphoid malignancies and thus may not require routine thromboprophylaxis. However individualized risk assessment based on the presence of additional prothrombotic factors should be considered to determine patients with lymphoid malignancies that may benefit from thromboprophylaxis