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Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma

BACKGROUND: Guidelines recommend thromboprophylaxis for patients with multiple myeloma (MM) at high risk for venous thromboembolism (VTE). However, the optimal risk prediction model for VTE in MM remains unclear. Khorana et al developed a VTE risk score (Khorana score) in ambulatory cancer patients...

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Autores principales: Sanfilippo, Kristen M., Carson, Kenneth R., Wang, Tzu‐Fei, Luo, Suhong, Edwin, Natasha, Kuderer, Nicole, Keller, Jesse M., Gage, Brian F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742966/
https://www.ncbi.nlm.nih.gov/pubmed/35028491
http://dx.doi.org/10.1002/rth2.12634
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author Sanfilippo, Kristen M.
Carson, Kenneth R.
Wang, Tzu‐Fei
Luo, Suhong
Edwin, Natasha
Kuderer, Nicole
Keller, Jesse M.
Gage, Brian F.
author_facet Sanfilippo, Kristen M.
Carson, Kenneth R.
Wang, Tzu‐Fei
Luo, Suhong
Edwin, Natasha
Kuderer, Nicole
Keller, Jesse M.
Gage, Brian F.
author_sort Sanfilippo, Kristen M.
collection PubMed
description BACKGROUND: Guidelines recommend thromboprophylaxis for patients with multiple myeloma (MM) at high risk for venous thromboembolism (VTE). However, the optimal risk prediction model for VTE in MM remains unclear. Khorana et al developed a VTE risk score (Khorana score) in ambulatory cancer patients receiving chemotherapy. We aimed to evaluate the predictive ability of the Khorana score in patients with MM. METHODS: We identified patients with MM within the Veterans Affairs health care system between 2006 and 2013. The Khorana score was calculated before treatment initiation. Using logistic regression, the relationship between risk group and VTE was assessed at 3 and 6 months. We tested model discrimination using the concordance statistic. RESULTS: In the cohort of 2870 patients with MM, there were 1328 at low risk (0 points), 1521 at intermediate risk (1‐2 points), and 21 at high risk (≥3 points) for VTE by the Khorana score. The 6‐month cumulative incidence of VTE was 5.1% (95% confidence interval [CI], 4.0%‐6.4%) in low risk, 3.9% (95% CI, 3.0%‐5.0%) in intermediate risk, 4.8% (95% CI, 0.3%‐20.2%) in high risk. The Khorana score did not strongly discriminate between patients who did and did not develop VTEs at 3 or 6 months (concordance statistic, 0.58; 95% CI, 0.54‐0.63; and 0.53, 95% CI, 0.50‐0.57, respectively. CONCLUSIONS: In conclusion, in this cohort of 2870 patients with MM, the Khorana score did not predict VTE. Our study supports the need to use myeloma‐specific risk models to predict VTE risk in patients with MM.
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spelling pubmed-87429662022-01-12 Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma Sanfilippo, Kristen M. Carson, Kenneth R. Wang, Tzu‐Fei Luo, Suhong Edwin, Natasha Kuderer, Nicole Keller, Jesse M. Gage, Brian F. Res Pract Thromb Haemost Original Articles BACKGROUND: Guidelines recommend thromboprophylaxis for patients with multiple myeloma (MM) at high risk for venous thromboembolism (VTE). However, the optimal risk prediction model for VTE in MM remains unclear. Khorana et al developed a VTE risk score (Khorana score) in ambulatory cancer patients receiving chemotherapy. We aimed to evaluate the predictive ability of the Khorana score in patients with MM. METHODS: We identified patients with MM within the Veterans Affairs health care system between 2006 and 2013. The Khorana score was calculated before treatment initiation. Using logistic regression, the relationship between risk group and VTE was assessed at 3 and 6 months. We tested model discrimination using the concordance statistic. RESULTS: In the cohort of 2870 patients with MM, there were 1328 at low risk (0 points), 1521 at intermediate risk (1‐2 points), and 21 at high risk (≥3 points) for VTE by the Khorana score. The 6‐month cumulative incidence of VTE was 5.1% (95% confidence interval [CI], 4.0%‐6.4%) in low risk, 3.9% (95% CI, 3.0%‐5.0%) in intermediate risk, 4.8% (95% CI, 0.3%‐20.2%) in high risk. The Khorana score did not strongly discriminate between patients who did and did not develop VTEs at 3 or 6 months (concordance statistic, 0.58; 95% CI, 0.54‐0.63; and 0.53, 95% CI, 0.50‐0.57, respectively. CONCLUSIONS: In conclusion, in this cohort of 2870 patients with MM, the Khorana score did not predict VTE. Our study supports the need to use myeloma‐specific risk models to predict VTE risk in patients with MM. John Wiley and Sons Inc. 2022-01-09 /pmc/articles/PMC8742966/ /pubmed/35028491 http://dx.doi.org/10.1002/rth2.12634 Text en © 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Sanfilippo, Kristen M.
Carson, Kenneth R.
Wang, Tzu‐Fei
Luo, Suhong
Edwin, Natasha
Kuderer, Nicole
Keller, Jesse M.
Gage, Brian F.
Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma
title Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma
title_full Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma
title_fullStr Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma
title_full_unstemmed Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma
title_short Evaluation of the Khorana score for prediction of venous thromboembolism in patients with multiple myeloma
title_sort evaluation of the khorana score for prediction of venous thromboembolism in patients with multiple myeloma
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742966/
https://www.ncbi.nlm.nih.gov/pubmed/35028491
http://dx.doi.org/10.1002/rth2.12634
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