Abstract |
Hemostatic complications are commonly encountered in blood or marrow transplantation (BMT) recipients, increasing their morbidity and mortality and are well described in the immediate post- transplantation period. The risk of venous thromboembolism (VTE) in long-term survivors of autologous BMT has not been studied previously. Patients who underwent autologous BMT between January 1, 1974, and December 31, 2010 for a hematologic malignancy, lived 2 years or more after transplantation, and were age ≥18 years were surveyed for long-term outcomes. The median duration of follow-up was 9.8 years (interquartile range, 6.4 to 14.3 years). We analyzed the risk of VTE in 820 autologous BMT recipients who survived for ≥2 years, compared with 644 siblings. BMT survivors were at a 2.6-fold higher risk of VTE compared with siblings (95% confidence interval [CI], 1.6 to 4.4; P =.0004), after adjusting for sociodemographic characteristics. Conditional on surviving for ≥2 years after BMT, the mean cumulative incidence of VTE was 3.9 ± .8% at 5 years and 6.1 ± 1.1% at 10 years. A diagnosis of plasma cell disorder (hazard ratio [HR], 2.37; 95% CI, 1.3 to 4.2; P = .004) and annual household income ≤$50,000 (HR, 2.02; 95% CI, 1.2 to 3.6; P = .015) were associated with increased VTE risk. Our data indicate that autologous BMT survivors are at elevated risk for developing late-occurring VTE. The development of risk prediction models to identify autologous BMT survivors at greatest risk for VTE and thromboprophylaxis may help decrease the morbidity and mortality associated with VTE.
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Authors | Radhika Gangaraju, Yanjun Chen, Lindsey Hageman, Jessica Wu, Liton Francisco, Kevin Battles, Michelle Kung, Emily Ness, Mariel Parman, Daniel J Weisdorf, Stephen J Forman, Mukta Arora, Saro H Armenian, Smita Bhatia |
Journal | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
(Biol Blood Marrow Transplant)
Vol. 25
Issue 11
Pg. 2261-2266
(11 2019)
ISSN: 1523-6536 [Electronic] United States |
PMID | 31278995
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Bone Marrow Transplantation
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Peripheral Blood Stem Cell Transplantation
- Risk Factors
- Siblings
- Survival Rate
- Transplantation, Autologous
- Venous Thromboembolism
(etiology, mortality, prevention & control)
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