J Thromb Haemost:血液系统癌症患者血栓栓塞和出血的风险

2019-05-07 xing.T 网络

大约有二分之二的血液系统癌症患者在10年内出现MI、缺血性卒中、VTE或需要住院治疗的出血。与一般人群队列相比,血液系统癌症队列具有更高的MI、缺血性卒中、VTE和需要医院治疗的出血风险。

治疗进步改善了血液系统癌症患者的存活率。反过来,患者可能出现血栓栓塞和出血事件的风险增加。近日,血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,研究人员旨在评估血液系统癌症患者的心肌梗塞(MI)、缺血性卒中、静脉血栓栓塞(VTE)和需要住院治疗的出血风险。

研究人员进行了一项丹麦人口为基础的队列研究(2000-2013),确定了所有成人血液系统癌症患者,并采用1:5比例在一般人群比较队列中进行抽样,所述比例与年龄、性别、既往血栓栓塞事件、出血和实体癌症患者相匹配。计算血栓栓塞和出血的十年绝对风险,并计算了控制了匹配因素的风险比(HRs)。

在32141名血液系统癌症患者中,血液系统癌症后任何血栓栓塞或出血并发症的10年绝对风险为19%:MI为3.3%,缺血性卒中为3.5%,VTE为5.2%,出血为8.5%。除髓细胞白血病、急性淋巴细胞白血病或骨髓增生异常综合征患者外,血栓栓塞事件的风险超过出血风险。与一般人群相比,血液系统癌症队列整体MI[HR=1.36,95%置信区间(CI):1.25-1.49]、缺血性卒中(HR=1.22,95%CI:1.12-1.33)、VTE(HR=3.37,95%CI:3.13-3.64)和出血(HR=2.39,95%CI:2.26-2.53)风险增加。 

大约有二分之二的血液系统癌症患者在10年内出现MI、缺血性卒中、VTE或需要住院治疗的出血。与一般人群队列相比,血液系统癌症队列具有更高的MI、缺血性卒中、VTE和需要医院治疗的出血风险。 

原始出处:

Kasper Adelborg.et al.Risk of thromboembolic and bleeding outcomes following hematological cancers: a Danish population‐based cohort study.Journal of Thrombosis and Haemostasis.2019.https://doi.org/10.1111/jth.14475

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