Venous thromboembolism risk in newly diagnosed lymphoma patients: a real-world prospective observational study from Vietnam National Cancer Hospital

Abstract

Background

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in cancer patients, with lymphoma being recognized as a high-risk malignancy. Real-world evidence from Southeast Asia, particularly Vietnam, remains limited. This study aimed to assess the incidence and risk factors for VTE among newly diagnosed lymphoma patients receiving systemic therapy in a real-world clinical setting.

Methods

We conducted a prospective descriptive study of 157 newly diagnosed Hodgkin and non-Hodgkin lymphoma patients treated at Vietnam National Cancer Hospital from January 2022 to January 2024. VTE risk was evaluated via the Khorana score at baseline and throughout chemotherapy. Doppler ultrasound and computed tomography were used for VTE screening. Multivariate logistic regression analysis identified independent risk factors for VTE.

Results

The incidence of VTE in this cohort was 8.3%, and patients were predominantly diagnosed at baseline (7.0%), with only two cases (1.3%) occurring during chemotherapy. The baseline Khorana risk assessment classified 68.2% of patients as low-risk and 7.6% as high-risk, with the proportion of high-risk patients decreasing progressively during treatment. Multivariate analysis revealed elevated pretreatment D-dimer levels (> 500 ng/mL; OR = 0.044, 95% CI: 0.003–0.632, p = 0.022) and cardiovascular comorbidities (OR = 0.036, 95% CI: 0.002–0.545, p = 0.016) as independent predictors of VTE.

Conclusion

Newly diagnosed lymphoma patients presented an 8.3% incidence of VTE, primarily at initial diagnosis. Elevated D-dimer levels and cardiovascular comorbidities independently predict increased thrombotic risk. The incorporation of routine D-dimer measurements and comprehensive clinical evaluations into standard pretreatment assessments could improve prophylactic strategies and patient outcomes in lymphoma care.