Development and validation of a nomogram model for predicting the risk of venous thromboembolism in lymphoma patients undergoing chemotherapy: a prospective cohort study conducted in China

Abstract

Background

The mechanism of Venous thromboembolism (VTE) is complicated and difficult to prevent due to factors such as bone marrow invasion, therapy, and immune-mediated effects. This study aims to establish a nomogram model for predicting the risk of thrombosis in lymphoma patients undergoing chemotherapy, which has been increasing over the past 30 years.

Methods

The data of lymphoma patients from the Affiliated Cancer Hospital of Chongqing University in China between 2018 and 2020 were analyzed. This included age, sex, body mass index, ECOG score, histological type, Ann Arbour Stage, white blood cells count, haemoglobin level, platelet count, D-dimer level, and chemotherapy cycle. Univariate and multivariate cox analysis was used to determine the risk factors for VTE. Characteristic variables were selected to construct a nomogram model which was then evaluated using ROC curve and calibration.

Results

Age, sex, PLT, D-dimer and chemotherapy cycle were considered as independent influencing factors of VTE. The mean (standard deviation) of the C index, AUC and Royston D statistics of 1000 cross-validations of the Nomogram model were 0.78 (0.01), 0.81 (0.01) and 1.61(0.07), respectively. It indicates a good calibration degree and applicability value as shown by the calibration curve. The DCA curve showed a rough threshold range of 0.05–0.60 with a good model.

Conclusions

We have established and validated a nomogram model for predicting the risk of thrombosis in lymphoma patients. This model can assess the risk of thrombosis in each individual patient, enabling the identification of high-risk groups and targeted preventive treatment.

Keywords:

• Venous thromboembolism
• nomogram
• lymphoma
• predict

Acknowledgements

We would like to thank all participants as no meaningful research could have been conducted without them.

Ethics approval and consent to participate

In our research, we followed the Declaration of Helsinki’s ethical principles concerning the use of human subjects in medical research. Chongqing University Cancer Hospital’s Ethics Committee reviewed and approved research studies(Approval Number -CZLS2021252-A).

Authors’ contributions

GL conceived and designed the study. XL and QX performed statistical analysis and interpretation. GL and QX drafted the manuscript. ZY and JL performed the data collection and cleaning. AS,GW and HL designed and substantively revised the article. All authors contributed to the article and approved the final manuscript.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available due to local legal requirements but are available from the corresponding author on reasonable request.

Additional information

Funding

Not applicable.