New model helps categorize cancer patients based on blood clot risk

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Physicians have an improved method for predicting blood clots in cancer patients, according to a study published in Blood (2010 Sep 9. [Epub ahead of print]).

The study, led by Ingrid Pabinger, MD, professor at the Medical University of Vienna, involved patients with newly diagnosed cancer or progression of the disease after remission. The cancer types among the 819 patients examined included brain, breast, lung, stomach, colorectal, pancreatic, kidney, prostate, and hematologic malignancies such as myeloma and lymphoma.

Researchers used an expanded version of a previously developed risk-scoring model to predict each patient's risk of venous thromboembolism (VTE). The patients were then categorized into high- and low-risk groups. VTE, the formation of blood clots in the veins, occurs in up to 20% of cancer patients and is a leading cause of death in that population.

“Because the risk of VTE is not equal in all cancer patients and anticoagulation in cancer patients results in a higher risk of bleeding complications, categorizing cancer patients according to their VTE risk is important,” said Dr. Pabinger. Patients with high risk of VTE may benefit from a preventive treatment for blood clotting such as routine thrombophrophylaxis, while low-risk patients tend to have a higher bleeding risk and may not be the best candidates for routine anticoagulation treatments.

The results of the study revealed that according to the new risk-scoring model, about one-third (35%) of cancer patients in the highest risk category developed VTE during the study, as opposed to only 1% of patients in the lowest risk category.

“Our expanded model demonstrates that cancer patients at a very high risk of VTE can be defined more precisely,” said Cihan Ay, MD, hematology fellow at the Clinical Division of Hematology and Hemostaseology at the Medical University of Vienna and co-author of the study. “This new model can help clinicians tailor their anticoagulant therapy and improve blood clotting prevention, which will maximize the clinical benefit and cost-effectiveness of disease prevention and minimize the risk of bleeding complications.”

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