Incidence of symptomatic venous thromboembolism following hematopoietic stem cell transplantation
Incidence of symptomatic venous thromboembolism following hematopoietic stem cell transplantation
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DOI：
10.1111/j.1538-7836.2008.03077.x
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发表时间：
2008-09-01
影响因子：
10.4
通讯作者：
Allan, D. S.
中科院分区：
文献类型：
--
作者：
Gonsalves, A.;Carrier, M.;Allan, D. S.
背景资料：造血干细胞移植（HSCT）后症状性静脉血栓栓塞（VTE）的发生率尚未得到很好的描述，特别是随着移植环境中门诊护理的使用增加。研究方法：回顾性分析了2000年至2005年在加拿大一家机构接受移植的589例患者（382例自体HSCT，207例同种异体HSCT），以确定HSCT患者近端深静脉血栓形成（DVT）或肺栓塞（PE）的发生率。结果：症状性VTE的1年总发生率为3.7% [95%置信区间（CI）2.5-5.6]。在HSCT患者中，7/589例（1.2%，95% CI 0.6-2.4）在HSCT后发生症状性非导管相关VTE（4例PE和3例DVT）。所有VTE事件均发生在造血移植后。接受自体HSCT的患者未接受血栓预防，而接受同种异体HSCT的大多数患者（79.7%）在移植前6 +/- 3天开始接受依诺肝素20 mg/天，平均22 +/- 14天，以预防肝静脉闭塞性疾病。结论：HSCT患者静脉血栓栓塞发生率高。在这些患者中可能应考虑血栓预防。然而，未来的研究需要评估血栓预防的风险和利益，在这个特定的人群。
Background: The incidence of symptomatic venous thromboembolism (VTE) following hematopoietic stem cell transplantation (HSCT) is not well described, particularly with increased use of ambulatory care in the transplant setting. Methods: A retrospective analysis involving 589 patients (382 autologous HSCT, 207 allogeneic HSCT) undergoing transplantation between 2000 and 2005 in a single Canadian institution was undertaken to identify the incidence of proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) in HSCT patients. Results: The total 1-year incidence of symptomatic VTE was 3.7% [95% confidence interval (CI) 2.5-5.6]. Among the HSCT patients, 7/589 (1.2%, 95% CI 0.6-2.4) developed symptomatic non-catheter-related VTE following HSCT (four PE and three DVT). All VTE events occurred after hematopoietic engraftment. Patients undergoing autologous HSCT did not receive thromboprophylaxis, whereas most patients undergoing allogeneic HSCT (79.7%) received enoxaparin 20 mg daily for the prevention of veno-occlusive disease of the liver, starting 6 +/- 3 days before transplantation for a mean of 22 +/- 14 days. Conclusion: HSCT patients have a high incidence of VTE. Thromboprophylaxis should potentially be considered in these patients. However, future studies assessing the risk and benefits of thromboprophylaxis are needed in this specific population.