Development and validation of Thrombosis Lymphoma (ThroLy) score

Darko Antic, Natasa Milic, Srdjan Nikolovski, Milena Todorovic, Jelena Bila, Predrag Djurdjevic, Bosko Andjelic, Vladislava Djurasinovic, Aleksandra Sretenovic, Vojin Vukovic, Jelena Jelicic, Suzanne Hayman, Biljana Mihaljevic

Overview

Venous thromboembolism is a significantly underestimated cancer complication, occurring in up to half of cancer patients and detecting in up to 20% of them during the course of their malignant disease. We have developed a multivariable predictive model for thromboembolic events risk assessment in patients with lymphoma. This newly defined Thrombosis Lymphoma (ThroLy) score is more specific for lymphoma patients than any other available score targeting thrombosis risk in cancer patients.

Summary

ThroLy score considers some particular characteristics of lymphoma patients, such as extranodal localization and mediastinal involvement. In addition to having a strong positive predictive value, the score is not limited to either hospitalized or outpatient settings, and does not require non-routine laboratory analyses.

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Author Comments

Dr. Srdjan Nikolovski, MD
Dr. Srdjan Nikolovski, MD
Clinical Center Serbia, University Children's Hospital, School of Medicine University of Belgrade
Research Associate
Clinical Research
Belgrade, Serbia | Yugoslavia
An idea to create new more precise model for predicting thromboembolic events in patients with hematological malignancies initiated an adventurous process which resulted in development of ThroLy score, which is certainly a great step to a successful prevention, early detection, and treatment of this type of complications in lymphoma patients. This is also a starting point to further validations and eventual implementation of ThroLy score into clinical guidelines and practice.Dr. Srdjan Nikolovski, MD

Resources

Article Web Page
https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.24466
Article Web Page
https://europepmc.org/article/med/27380861
ecancer.tv interview
https://ecancer.org/en/video/4890-decoding-the-risk-of-thromboembolic-events-in-lymphoma-patients

Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients.

Authors:
Dr. Srdjan Nikolovski, MD
Dr. Srdjan Nikolovski, MD
Clinical Center Serbia, University Children's Hospital, School of Medicine University of Belgrade
Research Associate
Clinical Research
Belgrade, Serbia | Yugoslavia

Am J Hematol 2016 Oct 22;91(10):1014-9. Epub 2016 Jul 22.

Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia, Belgrade.

Lymphoma patients are at increased risk of thromboembolic events but thromboprophylaxis in these patients is largely underused. We sought to develop and validate a simple model, based on individual clinical and laboratory patient characteristics that would designate lymphoma patients at risk for thromboembolic event. The study population included 1,820 lymphoma patients who were treated in the Lymphoma Departments at the Clinics of Hematology, Clinical Center of Serbia and Clinical Center Kragujevac. The model was developed using data from a derivation cohort (n = 1,236), and further assessed in the validation cohort (n = 584). Sixty-five patients (5.3%) in the derivation cohort and 34 (5.8%) patients in the validation cohort developed thromboembolic events. The variables independently associated with risk for thromboembolism were: previous venous and/or arterial events, mediastinal involvement, BMI>30 kg/m(2) , reduced mobility, extranodal localization, development of neutropenia and hemoglobin level < 100g/L. Based on the risk model score, the population was divided into the following risk categories: low (score 0-1), intermediate (score 2-3), and high (score >3). For patients classified at risk (intermediate and high-risk scores), the model produced negative predictive value of 98.5%, positive predictive value of 25.1%, sensitivity of 75.4%, and specificity of 87.5%. A high-risk score had positive predictive value of 65.2%. The diagnostic performance measures retained similar values in the validation cohort. Developed prognostic Thrombosis Lymphoma - ThroLy score is more specific for lymphoma patients than any other available score targeting thrombosis in cancer patients. Am. J. Hematol. 91:1014-1019, 2016. © 2016 Wiley Periodicals, Inc.

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http://dx.doi.org/10.1002/ajh.24466DOI Listing
October 2016
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4 Citations
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