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

Figures & data

Figure 1. Flowchart detailing the inclusion and exclusion criteria that resulted in the final study cohorts.

Table 1. Clinical characteristics of lymphoma patients with or without VTE.

Variables	Overall(n = 1069)	No-VTE (n = 1017)	VTE (n = 52)	P-value
Age (year, mean ± SD)	55.61 ± 14.44	55.36 ± 14.39	60.40 ± 14.79	0.014
Sex (%)				0.056
Female	635 (59.40)	597 (58.70)	38 (73.08)
Male	434 (40.60)	420 (41.30)	14 (26.92)
BMI (kg/m²,%)				0.297
< 24	646 (60.43)	618 (60.77)	28 (53.85)
24-28	353 (33.02)	331 (32.55)	22 (42.31)
≥28	70 (6.55)	68 (6.69)	2 (3.85)
ECOG (points, %)				0.028
0	337 (31.52)	316 (31.07)	21 (40.38)
1	558 (52.20)	540 (53.10)	18 (34.62)
≥2	174 (16.28)	161 (15.83)	13 (25.00)
Histological type (%)				0.059
Hodgkin	106 (9.92)	99 (9.73)	7 (13.46)
B cell	788 (73.71)	756 (74.34)	32 (61.54)
T cell	87 (8.14)	78 (7.67)	9 (17.31)
NK/T cell	88 (8.23)	84 (8.26)	4 (7.69)
Ann Arbor Stage (%)				0.774
I-II	381 (35.64)	361 (35.50)	20 (38.46)
III-IV	688 (64.36)	656 (64.50)	32 (61.54)
WBC (10^9/L, median [IQR])	5.77 [4.39, 7.73]	5.77 [4.40, 7.73]	5.82 [4.09, 7.50]	0.512
HB (g/L, median [IQR])	122 [106, 135]	122 [107, 136]	114.5 [95.75, 128.5]	<0.001
PLT (10^9/L, median [IQR])	197 [147, 271]	197 [147, 270]	202.5 [150.25, 279.0]	0.451
D-dimer (mg/L, mean ± SD)	120.11 ± 22.59	120.58 ± 22.54	110.87 ± 21.83	0.002
Chemotherapy cycle (%)
1-5	996 (93.17)	954 (93.81)	42 (80.77)
6-10	52 (4.86)	45 (4.42)	7 (13.46)
≥11	21 (1.96)	18 (1.77)	3 (5.77)

Table 2. Univariate and multivariate analysis of the risk factors for VTE.

Variables	HR (univariable)	HR (multivariate)
Age (year, mean ± SD)	1.03 (1.01–1.05, p = 0.007)	1.02 (1.00–1.04, p = 0.019)
Sex (%)
Female	1.00	1.00
Male	0.53 (0.28–0.97, p = 0.040)	0.51 (0.28–0.94, p = 0.032)
BMI (kg/m²,%)
< 24	1.00
24-28	1.43 (0.82–2.50, p = 0.212)
≥28	0.66 (0.16–2.79, p = 0.576)
ECOG (points,%)
0	1.00
1	0.53 (0.2–-0.99, p = 0.045)
≥2	1.18 (0.59–2.36, p = 0.639)
Histological type (%)
Hodgkin	1.00
B cell	0.69 (0.30–1.56, p = 0.366)
T cell	1.89 (0.70–5.11, p = 0.207)
NK/T cell	0.76 (0.22–2.61, p = 0.665)
Ann Arbor Stage (%)
I-II	1.00
III-IV	0.92 (0.52–1.60, p = 0.761)
WBC (10^9/L, median [IQR])	0.97 (0.91–1.04, p = 0.444)
HB (g/L, median [IQR])	0.98 (0.97–0.99, p < 0.001)	0.98 (0.97–0.99, p = 0.019)
PLT (10^9/L, median [IQR])	1.00 (1.0–1.01, p = 0.383)
D-dimer (mg/L, mean ± SD)	1.21 (1.13–1.29, p < 0.001)	1.19 (1.10–1.29, p < 0.001)
Chemotherapy cycle (%)
1-5	1.00	1.00
6-10	2.88 (1.29–6.44, p = 0.010)	3.70 (1.65–8.31, p = 0.002)
≥11	3.09 (0.95–10.00, p = 0.060)	2.65 (0.80–8.80, p = 0.112)

Figure 2. Nomogram model predicting 0.5-, 1- and 3-year VTE in lymphoma patients.

Figure 3. (A:0.5-, 1- And 3-year ROC curves for nomogram model, B:0.5-, 1- and 3-year calibration curves of nomogram model.).

Figure 4. 0.5-, 1- And 3-year DCA curves for nomogram models.

Figure 5. K-M curves of different risk levels to estimate the VTE of patients in two groups.

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.