Patients with chronic lymphocytic leukemia (CLL) or monoclonal B-cell lymphocytosis (MBL) are at increased risk for venous thromboembolism (VTE), according to research presented in a poster at JADPRO Live 2022, the annual APSHO meeting.
The study showed that about 1 in 12 patients with CLL or MBL developed VTE over a median follow-up of 6 years. The risk of VTE in patients with CLL/MBL was 6-fold higher than the risk in an age- and sex-matched cohort from the general population.
A team at the Mayo Clinic in Rochester, Minnesota, conducted this study to characterize the risk of VTE specific to MBL and CLL. The researchers identified patients with MBL or CLL diagnosed between 1998 and 2021 within 27 counties surrounding Rochester. Data were derived from the Mayo Clinic CLL Database and electronic health records.
The cohort included 904 patients with newly diagnosed CLL/MBL — 293 with MBL and 611 with CLL. At a median follow-up of 6 years (range, 1 day to 23 years), 70 patients developed VTE.
The rate of incident VTE in an age- and sex-matched population in Olmsted County, Minnesota, from 2001 to 2015 was pulled from the Rochester Epidemiology Project, for comparison with patients in the CLL/MBL cohort.
The overall VTE incidence was approximately 6 times higher in patients with CLL/MBL compared with the general population.
The risk of VTE was similar between patients with CLL and those with MBL (hazard ratio, 0.90; 95% CI, 0.49-1.65). The 5-year and 10-year cumulative risk of VTE was 4.9% and 11.5%, respectively.
VTE-provoking factors were identified in 47 patients (68%), including second active malignancy (45%), surgery (19%), hospitalization (13%), travel (9%), trauma (6%), line-associated VTE (6%), and immobility (2%).
Of the 70 patients who developed VTE, 63 received anticoagulation therapy. The remaining patients did not due to hospice transition (n=4), bleeding (n=2), and thrombocytopenia (n=1).
A total of 47 patients received time-limited anticoagulation therapy for a median of 3 months at first VTE, and 16 patients were placed on indefinite anticoagulation therapy at first VTE. Approximately 20% of patients on time-limited therapy experienced recurrent VTE, but there were no recurrences among patients on indefinite anticoagulation.
Based on these findings, the researchers concluded that increased vigilance and education on VTE is needed for patients with CLL or MBL, particularly if they have provoking factors such as an active second malignancy, hospitalization, surgery, or prolonged travel.
Disclosures: The study authors did not disclose any conflicts of interest.
Koehler AB, Achenbach SJ, Crusan DJ, Rabe KG, Ashrani AA, Parikh SA. Incidence of venous thromboembolism and patterns of anticoagulation in patients with monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia: A population-based study. Poster presented at: JADPRO Live 2022; October 20-23, 2022; Aurora, CO. Abstract JL1018C.