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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 (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 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 Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 5, 2007 Accepted January 19, 2008 Development and validation of a predictive model for chemotherapy-associated thrombosis Alok A. Khorana*, Nicole M. Kuderer, Eva Culakova, Gary H Lyman, and Charles W. Francis Department of Medicine, James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, United States Duke University Medical Center and the Duke Comprehensive Cancer Center, Durham, NC, United States * Corresponding author; email: alok_khorana{at}urmc.rochester.edu. 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 2,701 cancer outpatients from a prospective observational study. A risk model was derived and validated in an independent cohort of 1,365 patients from the same study. Five predictive variables were identified in a stage-adjusted multivariate model: site of cancer (2 points for very high risk site, 1 point for high risk site), platelet count 350,000/mm3, hemoglobin <10g/dL and/or use of erythropoiesis-stimulating agents, leukocyte count >11,000/mm3 and body mass index 35 kg/m2 (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 category (score3) over a median of 2.5 months (C-statistic= 0.7 for both cohorts). Thus, this model can identify cancer 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: R. Vormittag, R. Simanek, C. Ay, D. Dunkler, P. Quehenberger, C. Marosi, C. Zielinski, and I. Pabinger High Factor VIII Levels Independently Predict Venous Thromboembolism in Cancer Patients: The Cancer and Thrombosis Study Arterioscler Thromb Vasc Biol, December 1, 2009; 29(12): 2176 - 2181. [Abstract] [Full Text] [PDF] N. Kucher, D. Spirk, I. Baumgartner, L. Mazzolai, W. Korte, D. Nobel, M. Banyai, and H. Bounameaux Lack of prophylaxis before the onset of acute venous thromboembolism among hospitalized cancer patients: the SWIss Venous ThromboEmbolism Registry (SWIVTER) Ann. Onc., October 14, 2009; (2009) mdp406v1. [Abstract] [Full Text] [PDF] A. A. Khorana, M. B. Streiff, D. Farge, M. Mandala, P. Debourdeau, F. Cajfinger, M. Marty, A. Falanga, and G. H. Lyman Venous Thromboembolism Prophylaxis and Treatment in Cancer: A Consensus Statement of Major Guidelines Panels and Call to Action J. Clin. Oncol., October 10, 2009; 27(29): 4919 - 4926. [Abstract] [Full Text] [PDF] A. A. Khorana and G. C. Connolly Assessing Risk of Venous Thromboembolism in the Patient With Cancer J. Clin. Oncol., October 10, 2009; 27(29): 4839 - 4847. [Abstract] [Full Text] [PDF] G. H. Lyman and A. A. Khorana Cancer, Clots and Consensus: New Understanding of an Old Problem J. Clin. Oncol., October 10, 2009; 27(29): 4821 - 4826. [Full Text] [PDF] A. A. Khorana Cancer and thrombosis: implications of published guidelines for clinical practice Ann. Onc., October 1, 2009; 20(10): 1619 - 1630. [Abstract] [Full Text] [PDF] C. Ay, R. Vormittag, D. Dunkler, R. Simanek, A.-L. Chiriac, J. Drach, P. Quehenberger, O. Wagner, C. Zielinski, and I. Pabinger D-Dimer and Prothrombin Fragment 1 + 2 Predict Venous Thromboembolism in Patients With Cancer: Results From the Vienna Cancer and Thrombosis Study J. Clin. Oncol., September 1, 2009; 27(25): 4124 - 4129. [Abstract] [Full Text] [PDF] J. Fandrey and M. Dicato Examining the Involvement of Erythropoiesis-Stimulating Agents in Tumor Proliferation (Erythropoietin Receptors, Receptor Binding, Signal Transduction), Angiogenesis, and Venous Thromboembolic Events Oncologist, September 1, 2009; 14(suppl_1): 34 - 42. [Abstract] [Full Text] [PDF] N. Starling, S. Rao, D. Cunningham, T. Iveson, M. Nicolson, F. Coxon, G. Middleton, F. Daniel, J. Oates, and A. R. Norman Thromboembolism in Patients With Advanced Gastroesophageal Cancer Treated With Anthracycline, Platinum, and Fluoropyrimidine Combination Chemotherapy: A Report From the UK National Cancer Research Institute Upper Gastrointestinal Clinical Studies Group J. Clin. Oncol., August 10, 2009; 27(23): 3786 - 3793. [Abstract] [Full Text] [PDF] G. H Lyman Preventing Venous Thromboembolism in Cancer Patients: Can We Do Better? J. Oncol. Pract, July 1, 2009; 5(4): 165 - 166. [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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