Hematological Cancers Increase Long-Term Risk of Blood Clots, Bleeding Events

Patients with hematological cancers have a greater likelihood of experiencing serious complications, such as thromboembolic and bleeding events, according to a new study in the Journal of Thrombosis and Haemostasis.

Approximately 1 in 5 of these patients on average experience blood clots or bleeding events, according to the findings. Previous studies have either focused on only blood clots or bleeding, with this being the first study of an entire group of patients with hematological cancers. Hematologic cancer includes leukemia, bone marrow cancer, and cancers of the lymph nodes.

For the study, the researchers examined 32,141 adult patients with hematological cancers between the years 2000 and 2013 compared with a general population cohort. They analyzed 10-year absolute risks of thromboembolism and bleeding.

Overall, the researchers indicated that there were major differences in the prognoses for the different patient groups. Among the patients with hematological cancer, the 10-year absolute risk for any thromboembolic or bleeding complication following their cancer was 19%: 3.3% for myocardial infarction (MI), 3.5% for ischemic stroke, 5.2% for venous thromboembolism (VTE), and 8.5% for bleeding. With the exception of patients with myeloid leukemia, acute lymphoid leukemia, or myelodysplastic syndrome, the risk of thromboembolic events surpassed that of bleeding, according to the study.

Compared with the general population, the study showed a 40% higher risk of blood clot in the heart, 20% of blood clot in the brain, more than 300% of blood clot in the legs and lungs, and a 200% higher risk of bleeding among patients with hematologic cancer.

A better understanding of which patients are at increased risks of specific complications can help improve preventive efforts and guide individualized treatment, according to the researchers. Identifying which cancer types are at higher risk than others can allow for more targeted interventions.

“If a person has a high risk of suffering a blood clot, treatment with anticoagulant medicine can benefit some patients,” study author Kasper Adelborg, PhD, MD, from Aarhus University and Aarhus University Hospital, said in a press release. “But anticoagulant medicine is not desirable if the risk of suffering bleeding is higher. This is a difficult clinical problem, but our study can set goals for what carries most weight for each individual type of cancer.”

Tailoring treatment to a patient’s individual needs can mean weighing the overall risk of blood clots and bleeding, while taking into account the patient’s age, medical history, other diseases, and lifestyle, the researchers concluded.

References

Adelborg K, Corraini P, Darvalics B, 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