Thrombotic complications in adult patients with lymphoma: a meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events
Thrombotic complications in adult patients with lymphoma: a meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events
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DOI：
10.1182/blood-2010-01-258624
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发表时间：
2010-07-01
期刊：
影响因子：
20.3
通讯作者：
Donati, Maria Benedetta
中科院分区：
文献类型：
--
作者：
Caruso, Vanesa;Di Castelnuovo, Augusto;Donati, Maria Benedetta
血液系统恶性肿瘤中的血栓并发症具有重要的临床意义。在这项荟萃分析中，我们试图获得淋巴瘤患者血栓形成风险的准确估计。在电子数据库和参考文献中检索文章。确定了 18 篇文章（29 个队列、18018 名患者和 1149 个事件）。使用基于精确最大似然二项式分布的方法计算汇总发病率 (IR)。血栓形成的总体 IR 为 6.4%（95% 置信区间 [CI] 6.0%-6.8%）。静脉或动脉事件的总体 IR 分别为 5.3%（95% CI，5.0%-5.7%）和 1.1%（95% CI，0.9%-1.2%）。在非霍奇金淋巴瘤 (NHL) 受试者中观察到的血栓形成 IR 为 6.5%（95% CI，6.1%-6.9%），显着高于在霍奇金淋巴瘤患者中观察到的血栓形成 IR（4.7%；95% CI，3.9%-5.6%）。在 NHL 中，重度疾病患者的事件风险（IR 8.3%；95% CI，7.0%-9.9%）高于低度疾病患者（IR 6.3%；95% CI，4.5%-8.9%）。这项荟萃分析表明，淋巴瘤患者血栓形成的 IR 相当高，尤其是处于疾病晚期的 NHL 患者。这些结果可能有助于更好地确定血栓形成高风险的淋巴瘤人群，可以优先对这些人群采取预防措施。 （血。2010；115（26）：5322-5328）
Thrombotic complications in hematologic malignancies have important clinical implications. In this meta-analysis we sought to obtain accurate estimates of the thrombotic risk in lymphoma patients. Articles were searched in electronic data-bases and references. Eighteen articles were identified (29 cohorts, 18 018 patients and 1149 events). Pooled incidence rates (IRs) were calculated by the use of a method based on the exact maximum likelihood binomial distribution. The global IR of thrombosis was 6.4% (95% confidence interval [CI] 6.0%-6.8%). The global IRs of venous or arterial events were 5.3% (95% CI, 5.0%-5.7%) and 1.1% (95% CI, 0.9%-1.2%), respectively. The IR of thrombosis observed in subjects with non-Hodgkin lymphoma (NHL) was 6.5% (95% CI, 6.1%-6.9%), significantly greater than that observed for patients with Hodgkin lymphoma (4.7%; 95% CI, 3.9%-5.6%). Within NHL, patients with high-grade disease had a greater risk of events (IR 8.3%; 95% CI, 7.0%-9.9%) than low-grade disease (IR 6.3%; 95% CI, 4.5%-8.9%). This meta-analysis shows that the IR of thrombosis in lymphoma patients is quite high, especially in those with NHL at an advanced stage of the disease. These results may help better defining lymphoma populations at high thrombotic risk, to whom prophylactic approaches could be preferentially applied. (Blood. 2010; 115(26):5322-5328)