Risk of thromboembolic and bleeding outcomes following hematological cancers

A Danish population-based cohort study

Kasper Adelborg, Priscila Corraini, Bianka Darvalics, Henrik Frederiksen, Anne Ording, E. Puhó, Mikael Rørth, Henrik T. Sørensen

Research output: Contribution to journalArticle

Abstract

Background: Therapeutic advances have improved survival after hematological cancers. In turn, patients may be at increased risk of thromboembolic and bleeding events. Objectives: To examine the risks of myocardial infarction (MI), ischemic stroke, venous thromboembolism (VTE), and bleeding requiring hospital contact in patients with hematological cancers. Methods: We conducted a Danish population-based cohort study (2000-2013). We identified all adult hematological cancer patients and sampled a general population comparison cohort in a 1:5 ratio matched by age, sex, previous thromboembolic events, bleeding, and solid cancer. Ten-year absolute risks of thromboembolism and bleeding were calculated and hazard ratios (HRs) were computed, controlling for matching factors. Results: Among 32 141 hematological cancer patients, the 10-year absolute risk of any thromboembolic or bleeding complication following hematological cancer was 19%: 3.3% for MI, 3.5% for ischemic stroke, 5.2% for VTE, and 8.5% for bleeding. Except among patients with myeloid leukemia, acute lymphoid leukemia, or myelodysplastic syndrome, the risk of thromboembolic events surpassed that of bleeding. The hematological cancer cohort overall was at increased risk for MI [HR = 1.36, 95% confidence interval (CI): 1.25-1.49], ischemic stroke (HR = 1.22, 95% CI: 1.12-1.33), VTE (HR = 3.37, 95% CI: 3.13-3.64), and bleeding (HR = 2.39, 95% CI: 2.26-2.53) compared with the general population. Conclusions: Approximately 2 of 10 hematological cancer patients experienced MI, ischemic stroke, VTE, or bleeding requiring hospital contact within 10 years. The hematological cancer cohort had higher hazards of MI, ischemic stroke, VTE, and bleeding requiring hospital contact than a general population comparison cohort.

Original languageEnglish
JournalJournal of Thrombosis and Haemostasis
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Cohort Studies
Hemorrhage
Venous Thromboembolism
Population
Neoplasms
Stroke
Myocardial Infarction
Confidence Intervals
Myeloid Leukemia
Thromboembolism
Myelodysplastic Syndromes
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Survival

Keywords

  • cohort study
  • epidemiology
  • hematological cancer
  • myocardial infarction
  • stroke
  • venous thromboembolism

ASJC Scopus subject areas

  • Hematology

Cite this

Risk of thromboembolic and bleeding outcomes following hematological cancers : A Danish population-based cohort study. / Adelborg, Kasper; Corraini, Priscila; Darvalics, Bianka; Frederiksen, Henrik; Ording, Anne; Puhó, E.; Rørth, Mikael; Sørensen, Henrik T.

In: Journal of Thrombosis and Haemostasis, 01.01.2019.

Research output: Contribution to journalArticle

Adelborg, Kasper ; Corraini, Priscila ; Darvalics, Bianka ; Frederiksen, Henrik ; Ording, Anne ; Puhó, E. ; Rørth, Mikael ; Sørensen, Henrik T. / Risk of thromboembolic and bleeding outcomes following hematological cancers : A Danish population-based cohort study. In: Journal of Thrombosis and Haemostasis. 2019.
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T1 - Risk of thromboembolic and bleeding outcomes following hematological cancers

T2 - A Danish population-based cohort study

AU - Adelborg, Kasper

AU - Corraini, Priscila

AU - Darvalics, Bianka

AU - Frederiksen, Henrik

AU - Ording, Anne

AU - Puhó, E.

AU - Rørth, Mikael

AU - Sørensen, Henrik T.

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N2 - Background: Therapeutic advances have improved survival after hematological cancers. In turn, patients may be at increased risk of thromboembolic and bleeding events. Objectives: To examine the risks of myocardial infarction (MI), ischemic stroke, venous thromboembolism (VTE), and bleeding requiring hospital contact in patients with hematological cancers. Methods: We conducted a Danish population-based cohort study (2000-2013). We identified all adult hematological cancer patients and sampled a general population comparison cohort in a 1:5 ratio matched by age, sex, previous thromboembolic events, bleeding, and solid cancer. Ten-year absolute risks of thromboembolism and bleeding were calculated and hazard ratios (HRs) were computed, controlling for matching factors. Results: Among 32 141 hematological cancer patients, the 10-year absolute risk of any thromboembolic or bleeding complication following hematological cancer was 19%: 3.3% for MI, 3.5% for ischemic stroke, 5.2% for VTE, and 8.5% for bleeding. Except among patients with myeloid leukemia, acute lymphoid leukemia, or myelodysplastic syndrome, the risk of thromboembolic events surpassed that of bleeding. The hematological cancer cohort overall was at increased risk for MI [HR = 1.36, 95% confidence interval (CI): 1.25-1.49], ischemic stroke (HR = 1.22, 95% CI: 1.12-1.33), VTE (HR = 3.37, 95% CI: 3.13-3.64), and bleeding (HR = 2.39, 95% CI: 2.26-2.53) compared with the general population. Conclusions: Approximately 2 of 10 hematological cancer patients experienced MI, ischemic stroke, VTE, or bleeding requiring hospital contact within 10 years. The hematological cancer cohort had higher hazards of MI, ischemic stroke, VTE, and bleeding requiring hospital contact than a general population comparison cohort.

AB - Background: Therapeutic advances have improved survival after hematological cancers. In turn, patients may be at increased risk of thromboembolic and bleeding events. Objectives: To examine the risks of myocardial infarction (MI), ischemic stroke, venous thromboembolism (VTE), and bleeding requiring hospital contact in patients with hematological cancers. Methods: We conducted a Danish population-based cohort study (2000-2013). We identified all adult hematological cancer patients and sampled a general population comparison cohort in a 1:5 ratio matched by age, sex, previous thromboembolic events, bleeding, and solid cancer. Ten-year absolute risks of thromboembolism and bleeding were calculated and hazard ratios (HRs) were computed, controlling for matching factors. Results: Among 32 141 hematological cancer patients, the 10-year absolute risk of any thromboembolic or bleeding complication following hematological cancer was 19%: 3.3% for MI, 3.5% for ischemic stroke, 5.2% for VTE, and 8.5% for bleeding. Except among patients with myeloid leukemia, acute lymphoid leukemia, or myelodysplastic syndrome, the risk of thromboembolic events surpassed that of bleeding. The hematological cancer cohort overall was at increased risk for MI [HR = 1.36, 95% confidence interval (CI): 1.25-1.49], ischemic stroke (HR = 1.22, 95% CI: 1.12-1.33), VTE (HR = 3.37, 95% CI: 3.13-3.64), and bleeding (HR = 2.39, 95% CI: 2.26-2.53) compared with the general population. Conclusions: Approximately 2 of 10 hematological cancer patients experienced MI, ischemic stroke, VTE, or bleeding requiring hospital contact within 10 years. The hematological cancer cohort had higher hazards of MI, ischemic stroke, VTE, and bleeding requiring hospital contact than a general population comparison cohort.

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KW - epidemiology

KW - hematological cancer

KW - myocardial infarction

KW - stroke

KW - venous thromboembolism

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