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Unprovoked venous thromboembolism is associated with a 5 to 27% annual risk of recurrence after discontinuation of anticoagulation, and indefinite anticoagulation is recommended if the bleeding risk is low to moderate. However, in one-third of patients with unprovoked venous thromboembolism, the risk of recurrence is so low (<5% per year) that anticoagulant therapy >3–6 months may not be necessary. Several prediction rules were derived to identify patients with unprovoked venous thromboembolism who have a low recurrence risk. In 2016, we presented our results of the original DAMOVES, a nomogram for prediction of recurrence in an individual patient with unprovoked venous thromboembolism. The aim of this study was to externally validate this nomogram in patients with unprovoked venous thromboembolism.

Little is known about whether risk classification at diagnosis predicts post-hematopoietic cell transplantation (HCT) outcomes for acute myeloid leukemia (AML) patients. We evaluated 8709 AML patients from the CIBMTR database and, after selection and manual curation of cytogenetics data, 3779 patients in CR1 were included in the final analysis: 2384 with intermediate-risk, 969 with adverse-risk, and 426 with KMT2A-rearranged disease. An adjusted multivariable analysis compared to intermediate-risk patients detected an increased risk of relapse for KMT2A-rearranged and adverse-risk patients (HR 1.27, p = 0.01 and HR 1.71, p &lt; 0.001, respectively). Leukemia-free survival (LFS) was similar for KMT2A and adverse-risk patients (HR 1.26, p = 0.002 and HR 1.47, p &lt; 0.001), as was overall survival (OS) (HR 1.32, p &lt; 0.001 and HR 1.45, p &lt; 0.001). No differences in outcome could be detected when patients were stratified by KMT2A fusion partner. This is the largest study conducted to date on post-HCT outcomes in AML using manually curated cytogenetics for risk stratification. Our work demonstrates that risk classification at diagnosis remains predictive of post-HCT outcomes in AML. It also highlights the critical need to develop novel treatment strategies for patients with KMT2A rearrangements and adverse-risk disease.

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