Increased risk of chemotherapy-associated venous thromboembolism in elderly patients with cancer

Matteo Vergati, David Della Morte, Patrizia Ferroni, Vittore Cereda, Livia Tosetto, Francesca La Farina, Fiorella Guadagni, Mario Roselli

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Data on the relationship between aging, chemotherapy, and risk for venous thromboembolism (VTE) are controversial. We sought to evaluate the risk of chemotherapy-associated VTE in young to middle-aged (YMA) and elderly cancer patients and to analyze the VTE-free survival time in both groups. Patients with histologically confirmed diagnosis of solid malignancy receiving any type of systemic chemotherapy, no clinical diagnosis of VTE before chemotherapy initiation, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤2 were enrolled in this study. Of the 486 consecutive patients included in the study, 380 (78%) were classified as YMA (≤70 years of age) and 106 (22%) as elderly (>70 years of age). At a median follow-up of 1 year, the incidence of VTE events was almost two-fold greater in elderly than in YMA (11% vs. 6%). Age (≤70 years vs. >70 years (hazard ratio [HR], 2.42; 95% confidence interval [CI] 1.15-5.06; p=0.020), ECOG-PS (HR, 6.54; 95% CI 3.10-13.8; p<0.0001), and platinum-based chemotherapy (HR, 2.46; 95% CI 1.06-5.69; p=0.035) were independent risk factors for VTE. In the elderly subset, a trend toward an increased risk of VTE in patients receiving a platinum-based chemotherapy when compared with a non-platinum-containing regimen was observed (15% vs. 9.1%). The Kaplan-Meier analysis showed that elderly patients had a significantly shorter VTE-free survival time compared with younger cancer patients (log-rank test=2.0; p=0.045). Our study reports an increase incidence of VTE in elderly cancer patients treated with chemotherapy compared with the younger group, suggesting that aging is one of the most important risk factors for VTE. On the basis of the results of this study, we believe that a validated predictive model including age, ECOG-PS, and type of chemotherapy (platinum-vs. non-platinum containing regimen) would enable clinicians to target thromboprophylaxis to those patients considered to be at greatest risk.

Original languageEnglish
Pages (from-to)224-231
Number of pages8
JournalRejuvenation Research
Volume16
Issue number3
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

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Venous Thromboembolism
Drug Therapy
Neoplasms
Platinum
Confidence Intervals
Survival
Incidence
Kaplan-Meier Estimate

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Increased risk of chemotherapy-associated venous thromboembolism in elderly patients with cancer. / Vergati, Matteo; Della Morte, David; Ferroni, Patrizia; Cereda, Vittore; Tosetto, Livia; La Farina, Francesca; Guadagni, Fiorella; Roselli, Mario.

In: Rejuvenation Research, Vol. 16, No. 3, 01.06.2013, p. 224-231.

Research output: Contribution to journalArticle

Vergati, M, Della Morte, D, Ferroni, P, Cereda, V, Tosetto, L, La Farina, F, Guadagni, F & Roselli, M 2013, 'Increased risk of chemotherapy-associated venous thromboembolism in elderly patients with cancer', Rejuvenation Research, vol. 16, no. 3, pp. 224-231. https://doi.org/10.1089/rej.2013.1409
Vergati, Matteo ; Della Morte, David ; Ferroni, Patrizia ; Cereda, Vittore ; Tosetto, Livia ; La Farina, Francesca ; Guadagni, Fiorella ; Roselli, Mario. / Increased risk of chemotherapy-associated venous thromboembolism in elderly patients with cancer. In: Rejuvenation Research. 2013 ; Vol. 16, No. 3. pp. 224-231.
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