Patterns of Venous Thromboembolism Prophylaxis during Treatment of Acute Leukemia: Results of a North American Web-Based Survey

Eun Ju Lee, B. Douglas Smith, Jessica W. Merrey, Alfred I. Lee, Nikolai A. Podoltsev, Lisa Barbarotta, Mark R Litzow, Thomas Prebet, Selina M. Luger, Steven Gore, Michael B. Streiff, Amer M. Zeidan

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Venous thromboembolism (VTE) occurs in 2% to 12% of patients with acute leukemia (AL) despite disease- and therapy-associated thrombocytopenia, and it can be associated with significant morbidity and mortality. Because of the few high-quality studies, there are no evidence-based guidelines for VTE prophylaxis in this patient population. We sought to determine the spectrum of practice regarding prevention of VTE in patients with AL during induction and consolidation therapies. Methods We conducted a 19-question Web-based survey directed at North American providers caring for these patients. One hundred fifty-one of 215 responses received were eligible for analysis, with a response rate of 20.9% among physicians who treated leukemias. Results Overall, 47% and 45% of providers reported using pharmacologic VTE prophylaxis during induction and consolidation phases, respectively. Approximately 15% of providers did not provide any VTE prophylaxis, while 36% used mechanical methods and ambulation. Among providers who did not recommend pharmacologic prophylaxis, the most commonly cited reasons were the perceived high risk of bleeding (51%), absence of data supporting use (38%), and perceived low risk of VTE (11%). Conclusion Large, prospective studies are needed to define the safest and most effective approach to VTE prevention in patients with AL.

Original languageEnglish (US)
Pages (from-to)766-770e4
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number12
DOIs
StatePublished - Dec 1 2015

Fingerprint

Venous Thromboembolism
Leukemia
Therapeutics
Surveys and Questionnaires
Thrombocytopenia
Walking
Prospective Studies
Guidelines
Hemorrhage
Morbidity
Physicians
Mortality
Population

Keywords

  • Acute leukemia
  • Acute lymphoid leukemia
  • Acute myeloid leukemia
  • Deep venous thrombosis
  • Patterns of practice

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Patterns of Venous Thromboembolism Prophylaxis during Treatment of Acute Leukemia : Results of a North American Web-Based Survey. / Lee, Eun Ju; Smith, B. Douglas; Merrey, Jessica W.; Lee, Alfred I.; Podoltsev, Nikolai A.; Barbarotta, Lisa; Litzow, Mark R; Prebet, Thomas; Luger, Selina M.; Gore, Steven; Streiff, Michael B.; Zeidan, Amer M.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 15, No. 12, 01.12.2015, p. 766-770e4.

Research output: Contribution to journalArticle

Lee, EJ, Smith, BD, Merrey, JW, Lee, AI, Podoltsev, NA, Barbarotta, L, Litzow, MR, Prebet, T, Luger, SM, Gore, S, Streiff, MB & Zeidan, AM 2015, 'Patterns of Venous Thromboembolism Prophylaxis during Treatment of Acute Leukemia: Results of a North American Web-Based Survey', Clinical Lymphoma, Myeloma and Leukemia, vol. 15, no. 12, pp. 766-770e4. https://doi.org/10.1016/j.clml.2015.07.637
Lee, Eun Ju ; Smith, B. Douglas ; Merrey, Jessica W. ; Lee, Alfred I. ; Podoltsev, Nikolai A. ; Barbarotta, Lisa ; Litzow, Mark R ; Prebet, Thomas ; Luger, Selina M. ; Gore, Steven ; Streiff, Michael B. ; Zeidan, Amer M. / Patterns of Venous Thromboembolism Prophylaxis during Treatment of Acute Leukemia : Results of a North American Web-Based Survey. In: Clinical Lymphoma, Myeloma and Leukemia. 2015 ; Vol. 15, No. 12. pp. 766-770e4.
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abstract = "Background Venous thromboembolism (VTE) occurs in 2{\%} to 12{\%} of patients with acute leukemia (AL) despite disease- and therapy-associated thrombocytopenia, and it can be associated with significant morbidity and mortality. Because of the few high-quality studies, there are no evidence-based guidelines for VTE prophylaxis in this patient population. We sought to determine the spectrum of practice regarding prevention of VTE in patients with AL during induction and consolidation therapies. Methods We conducted a 19-question Web-based survey directed at North American providers caring for these patients. One hundred fifty-one of 215 responses received were eligible for analysis, with a response rate of 20.9{\%} among physicians who treated leukemias. Results Overall, 47{\%} and 45{\%} of providers reported using pharmacologic VTE prophylaxis during induction and consolidation phases, respectively. Approximately 15{\%} of providers did not provide any VTE prophylaxis, while 36{\%} used mechanical methods and ambulation. Among providers who did not recommend pharmacologic prophylaxis, the most commonly cited reasons were the perceived high risk of bleeding (51{\%}), absence of data supporting use (38{\%}), and perceived low risk of VTE (11{\%}). Conclusion Large, prospective studies are needed to define the safest and most effective approach to VTE prevention in patients with AL.",
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AU - Lee, Alfred I.

AU - Podoltsev, Nikolai A.

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AU - Litzow, Mark R

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N2 - Background Venous thromboembolism (VTE) occurs in 2% to 12% of patients with acute leukemia (AL) despite disease- and therapy-associated thrombocytopenia, and it can be associated with significant morbidity and mortality. Because of the few high-quality studies, there are no evidence-based guidelines for VTE prophylaxis in this patient population. We sought to determine the spectrum of practice regarding prevention of VTE in patients with AL during induction and consolidation therapies. Methods We conducted a 19-question Web-based survey directed at North American providers caring for these patients. One hundred fifty-one of 215 responses received were eligible for analysis, with a response rate of 20.9% among physicians who treated leukemias. Results Overall, 47% and 45% of providers reported using pharmacologic VTE prophylaxis during induction and consolidation phases, respectively. Approximately 15% of providers did not provide any VTE prophylaxis, while 36% used mechanical methods and ambulation. Among providers who did not recommend pharmacologic prophylaxis, the most commonly cited reasons were the perceived high risk of bleeding (51%), absence of data supporting use (38%), and perceived low risk of VTE (11%). Conclusion Large, prospective studies are needed to define the safest and most effective approach to VTE prevention in patients with AL.

AB - Background Venous thromboembolism (VTE) occurs in 2% to 12% of patients with acute leukemia (AL) despite disease- and therapy-associated thrombocytopenia, and it can be associated with significant morbidity and mortality. Because of the few high-quality studies, there are no evidence-based guidelines for VTE prophylaxis in this patient population. We sought to determine the spectrum of practice regarding prevention of VTE in patients with AL during induction and consolidation therapies. Methods We conducted a 19-question Web-based survey directed at North American providers caring for these patients. One hundred fifty-one of 215 responses received were eligible for analysis, with a response rate of 20.9% among physicians who treated leukemias. Results Overall, 47% and 45% of providers reported using pharmacologic VTE prophylaxis during induction and consolidation phases, respectively. Approximately 15% of providers did not provide any VTE prophylaxis, while 36% used mechanical methods and ambulation. Among providers who did not recommend pharmacologic prophylaxis, the most commonly cited reasons were the perceived high risk of bleeding (51%), absence of data supporting use (38%), and perceived low risk of VTE (11%). Conclusion Large, prospective studies are needed to define the safest and most effective approach to VTE prevention in patients with AL.

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