Predictors and timing of venous thromboembolism and overall survival in lymphoma

Current guidelines recommend consideration of prophylactic anticoagulation in lymphoma, supported by the Khorana score, which assigns lymphoma 1 point for risk of developing venous thromboembolism (VTE). We hypothesized that different lymphoma types convey different risk of VTE. To better characterize VTE rates and predictive parameters, we assessed lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE) events in 879 lymphoma patients. VTE was found in 4.9%, with a higher incidence rate among patients with aggressive lymphoma (8.3%), compared with indolent lymphoma (1.9%) and Hodgkin lymphoma (0%). The International Prognostic Index (IPI) was a strong predictor of VTE. The Khorana score did not predict VTE within lymphoma but was and independent risk factor for mortality. VTE was also an independent risk factor for mortality. Our study confirms that lymphoma subtypes are associated with different VTE risks.