Venous thromboembolism following hematopoietic stem cell transplantation—a systematic review and meta-analysis

Mohammad Faizan Zahid, M. Hassan Murad, Mark R. Litzow, William J. Hogan, Mrinal S. Patnaik, Alok Khorana, Alex C. Spyropoulos, Shahrukh K. Hashmi

Research output: Contribution to journalReview article

21 Scopus citations

Abstract

Venous thromboembolism (VTE) is a common complication of hematopoietic stem cell transplantation (HSCT). Graft-versus-host disease (GVHD) is another complication of HSCT that may modify the risk of VTE. Our objective was to explore the incidence of VTE (deep venous thrombosis and pulmonary embolism) following HSCT and to evaluate its association with GVHD. A comprehensive search of Medline In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus was conducted to search for both retrospective and prospective HSCT studies which had reported VTE. Random-effects meta-analysis was used to pool incidence rates. We included 17 studies reporting on allogeneic- and 10 on autologous-HSCT; enrolling 6693 patients; of which 5 were randomized. The overall incidence of VTE after HSCT was 5 % (4–7 %). Incidence in allogeneic-HSCT was 4 % (2–6 %) and in autologous-HSCT was 4 % (1–15 %). Eleven and nine studies reported data on acute and chronic GVHD, respectively. The incidence of VTE in chronic GVHD was 35 % (20–54 %), whereas in acute GVHD it was 47 % (32–62 %). Based on the results of this meta-analysis, VTE is a fairly common complication after HSCT, emphasizing the importance of assimilating guidelines for both treatment and prophylaxis in this patient population.

Original languageEnglish (US)
Pages (from-to)1457-1464
Number of pages8
JournalAnnals of hematology
Volume95
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Bone marrow transplantation
  • Complication
  • Deep venous thrombosis
  • Hematopoietic stem cell transplantation
  • Pulmonary embolism
  • Venous thromboembolism

ASJC Scopus subject areas

  • Hematology

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