High incidence of venous thromboembolism and major bleeding in patients with primary CNS lymphoma

Abstract

Venous thromboembolism (VTE) and major bleeding in primary central nervous system lymphoma (PCNSL) patients are not well described. We identified 992 PCNSL patients using the California Cancer Registry (2005–2014). The cumulative incidence of VTE and major bleeding was determined using California hospitalization data. The 12-month cumulative incidence of VTE was 13.6% (95% confidence interval (CI) 11.5–15.8%); chemotherapy and radiation therapy were associated with increased risk of VTE (hazard ratio (HR) 2.41, CI 1.31–4.46 and HR 1.56, CI 1.08–2.25, respectively). The 12-month cumulative incidence of major bleeding was 12.4% (CI 10.1–14.6%). Pulmonary embolism (PE) and proximal deep vein thrombosis were associated with increased risk of major bleeding, likely due to anticoagulation. PE (HR 1.61, CI 1.11–2.33, p=.011) and major bleeding (HR 2.36, CI 1.82–3.06, p<.0001) were associated with increased mortality. This study highlights the high incidence of both VTE and major bleeding and the significant impact on survival for PCNSL patients.

Keywords:

• Venous thromboembolism
• CNS lymphoma
• major bleeding

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This study is supported by UL1 TR00001860, National Center for Advancing Translational Science (NCATS), NIH (TW) and by the UC Davis Paul Calabresi Career Development Award for Clinical Oncology as funded by the National Cancer Institute/National Institutes of Health through grant #5K12-CA138464 (ASR). The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute.