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Blood, 15 May 2008, Vol. 111, No. 10, pp. 4902-4907. Prepublished online as a Blood First Edition Paper on January 23, 2008; DOI 10.1182/blood-2007-10-116327. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-10-116327v1 111/10/4902    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Khorana, A. A. Articles by Francis, C. W. Search for Related Content PubMed PubMed Citation Articles by Khorana, A. A. Articles by Francis, C. W. Related Collections Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Development and validation of a predictive model for chemotherapy-associated thrombosis Alok A. Khorana1, Nicole M. Kuderer2, Eva Culakova2, Gary H. Lyman2, and Charles W. Francis1 1 James P. Wilmot Cancer Center and the Department of Medicine, University of Rochester, NY; and 2 Duke University Medical Center and the Duke Comprehensive Cancer Center, Durham, NC Risk of venous thromboembolism (VTE) is elevated in cancer, but individual risk factors cannot identify a sufficiently high-risk group of outpatients for thromboprophylaxis. We developed a simple model for predicting chemotherapy-associated VTE using baseline clinical and laboratory variables. The association of VTE with multiple variables was characterized in a derivation cohort of 2701 cancer outpatients from a prospective observational study. A risk model was derived and validated in an independent cohort of 1365 patients from the same study. Five predictive variables were identified in a multivariate model: site of cancer (2 points for very high-risk site, 1 point for high-risk site), platelet count of 350 x 109/L or more, hemoglobin less than 100 g/L (10 g/dL) and/or use of erythropoiesis-stimulating agents, leukocyte count more than 11 x 109/L, and body mass index of 35 kg/m2 or more (1 point each). Rates of VTE in the derivation and validation cohorts, respectively, were 0.8% and 0.3% in low-risk (score = 0), 1.8% and 2% in intermediate-risk (score = 1-2), and 7.1% and 6.7% in high-risk (score 3) category over a median of 2.5 months (C-statistic = 0.7 for both cohorts). This model can identify patients with a nearly 7% short-term risk of symptomatic VTE and may be used to select cancer outpatients for studies of thromboprophylaxis. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Thromboprophylaxis in cancer outpatients Carine J. M. Doggen Blood 2008 111: 4833. [Full Text] [PDF] This article has been cited by other articles: A. A. Khorana Cancer and thrombosis: implications of published guidelines for clinical practice Ann. Onc., June 26, 2009; (2009) mdp068v1. [Abstract] [Full Text] [PDF] G. H. Ku, R. H. White, H. K. Chew, D. J. Harvey, H. Zhou, and T. Wun Venous thromboembolism in patients with acute leukemia: incidence, risk factors, and effect on survival Blood, April 23, 2009; 113(17): 3911 - 3917. [Abstract] [Full Text] [PDF] T. Sousou and A. A. Khorana New Insights Into Cancer-Associated Thrombosis Arterioscler. Thromb. Vasc. Biol., March 1, 2009; 29(3): 316 - 320. [Abstract] [Full Text] [PDF] A. A. Khorana and G. H. Lyman Incidence and Prevention of Cancer-associated Thrombosis ASCO Educational Book, January 1, 2009; 2009(1): 321 - 325. [Abstract] [Full Text] [PDF] Assessing Risk for Cancer-Related Thrombosis Journal Watch Oncology and Hematology, June 3, 2008; 2008(603): 2 - 2. [Full Text]

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