High incidence of thromboembolism in patients with central nervous system lymphoma

Goldschmidt, Neta; Linetsky, Eduard; Shalom, Rose; Varon, David; Siegal, Tali

doi:10.1002/cncr.11623

Cited by 84 publications

(58 citation statements)

References 15 publications

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“…In our study we showed significantly higher incidence of TE in patients with hgNHL younger than 60 years of age, which is in contrast to the most of earlier studies. Similar to one of the earlier researches which showed higher incidence in patients with CNS lymphoma [11], we also showed the same result, although without statistical significance. Analysis of data of TE incidence in research of Mohren et al [12] has not been made in group of patients with lgNHL because of patients with CLL was included in this group.…”

Section: Discussionsupporting

confidence: 91%

“…A couple of studies analyzed the incidence of thromboembolism in patients with haematologic malignancies. Earlier studies showed an increased incidence of thrombosis in patients with high grade non-Hodgkin lymphoma (hgNHL), Hodgkin lymphoma (HL) and CNS lymphoma [9][10][11][12]. Some studies also showed an increased risk of NHL and HL in patients within a year after a venous thromboembolism [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of incidence of thromboembolic complications in patients with chronic lymphoproliferative diseases

Nikolovski¹

2015

Med podmladak

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SažetakUvod: Kod pacijenata sa solidnim tumorima uočen je povećan rizik za nastanak tromboembolija, međutim za pacijente sa malignim limfomima postoji malo podataka.Cilj: Cilj ovog rada bio je odrediti incidencu TE kod pacijenata sa non-Hodžkin limfomima (NHL), Hodžkin limfomima (HL) i hroničnom limfocitnom leukemijom (HLL) koji su zbrinuti u našoj instituciji.Materijal i metode: Evaluirali smo istorije bolesti pacijenata sa NHL, HL i HLL dijagnostifikovanih u skladu sa klasifikacijom SZO i lečenih u našoj ustanovi između januara 2006. i decembra 2014. godine.Rezultati: Od ukupno 1054 pacijenta, 48,4% imalo je NHL visokog gradusa, 20,0% NHL niskog gradusa, 14,5% HL, 7,1% imalo je druge forme limfoma i 10,0% HLL. U grupi pacijenata sa limfomima, 72 (6,8%) imalo je najmanje jednu TE. TE je uključivala trombozu dubokih vena (38,9%), trombozu jugularnih vena (12,5%), plućnu emboliju (11,1%), trombozu CNS (6,9%), trombozu površinskih vena (2,8%), akutni infarkt miokarda (1,4%) i ostalo (26,4%). Kod 49 pacijenata tromboza se pojavila u toku terapije ili do tri meseca nakon završet-ka terapije, dok je kod 23 pacijenta tromboza dijagnostifikovana pre terapije. Pacijenti sa agresivnim formama NHL i HLL imali su značajno veću incidencu TE (8,63%, 8,57%) u poređenju sa pacijentima sa drugim tipovima limfoma (p = 0,009). Nije postojao statistički značajno povećan rizik od TE u zavisnosti od tipa limfoproliferativne bolesti.Zaključak: Ova studija je potvrdila rezultate ranijih studija o povećanom riziku od tromboembolijskih događaja (TE) kod pacijenata sa agresivnim oblicima hroničnih limfoproliferatvnih bolest, ali i da ne postoji statistički značajna razlika u odnosu na pol i godine.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Analysis of incidence of thromboembolic complications in patients with chronic lymphoproliferative diseases

Nikolovski¹

2015

Med podmladak

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“…The association between malignancy and thrombosis is well-recognized and occurs in 15% of all cancer patients. 8 The risk of VTE in the setting of a brain tumor is high, affecting 28% of patients with malignant gliomas. 8 Predisposing risk factors other than the inherent risk of malignancy include the presence of leg paresis, histologic diagnosis of glioblastoma multiforme, age $60 years, large tumor size, and use of chemotherapy.…”

Section: Sectionmentioning

confidence: 99%

“…Almost all events occurred in the first 3 months of treatment. 8 DISCUSSION A vanishing tumor is a complex diagnostic dilemma and is not specific for one disease. The clinical course of a vanishing tumor, with the exception of PCNSL, has not been completely described.…”

Section: Sectionmentioning

confidence: 99%

Clinical Reasoning: Vanishing tumor

et al. 2015

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In 2005, a 60-year-old man presented to the hospital complaining of a 2-month history of headaches and lethargy. His medical history included osteoarthritis and hypertension. From a social perspective, he was married with children, drove a truck for a living, and had never traveled abroad. His family history was unremarkable. Investigations included a brain CT, which highlighted an enhancing, spaceoccupying lesion in the left basal ganglia with associated edema and mass effect (figure, A). He was prescribed high-dose dexamethasone while awaiting a neurosurgical review. One week later, a prebiopsy, contrast-enhanced CT showed a reduction in the size of the caudate head mass (figure, B). MRI brain with gadolinium showed small white matter changes and no mass was evident. He did not proceed to biopsy and was subsequently observed. CSF analysis was abnormal, revealing mature, lymphoid cells and some larger immature cells, some of which appeared plasmacytoid (B cell). Although suspicious for lymphoma, this result was nondiagnostic. The CSF protein level was 331. CSF low-density lipoprotein, Epstein-Barr virus, and flow cytometry were not performed. The b2-microglobulin level and serum low-density lipoprotein were normal. Serology for cytomegalovirus and toxoplasma were negative, as were ELISA for Toxocara and HIV screen. Slit-lamp examination was unremarkable. He was discharged, but readmitted 2 weeks later with a deep vein thrombosis. Repeat CSF cytology was again nondiagnostic. CSF was not examined for oligoclonal bands or myelin basic protein. A bone marrow biopsy and staging CT had normal results. Whole body PET/CT was unavailable.Questions for consideration:

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“…Certain patients, (those with a malignant diagnosis or an inherited coagulopathy) are at increased risk for this complication. The incidence of venous thromboembolism in patients with malignant disease ranges from 2% to 60% (46)(47)(48)(49). As a result of the increased risk for thromboembolic complications, some oncologists are concerned about the use of OC and estrogens in patients with a malignant diagnosis.…”

Section: Patients Who Are Not Candidates For Estrogenmentioning

confidence: 99%

Therapeutic Amenorrhea in Patients at Risk for Thrombocytopenia

Martin-Johnston¹,

Okoji²,

Armstrong³

2008

Obstetrical &Amp; Gynecological Survey

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To examine the need for and evaluate the method of menses suppression in women at risk for thrombocytopenia. A systematic review of the published literature in MEDLINE using the search terms thrombocytopenia, menorrhagia, therapeutic amenorrhea, progestin intrauterine device, combination oral contraceptive-extended and cyclic, gonadotropin releasing hormone agonist, danazol, and progestins. There are an increased number of reproductive age women at risk for thrombocytopenia who would benefit from menses suppression. A number of effective medical regimens are available. In patients who fail medical therapy, endometrial ablation appears to be effective in women with thrombocytopenia. As a result of the increased number of women at risk for thrombocytopenia, there is a need for therapeutic amenorrhea. The type of regimen selected depends upon the patients need for contraception and the ability to tolerate estrogen-containing medications. For women who fail medical therapy, there are surgical options, which are associated with less morbidity than hysterectomy.Dysfunctional uterine bleeding is one of the most common complaints in the field of obstetrics and gynecology (1). The incidence of menorrhagia and abnormal uterine bleeding is about 5% in the general population (2), and a cause is identified in only 50% of affected individuals (3). Patients with thrombocytopenia are at particular risk for gynecologic bleeding complications. Almost half of patients with thrombocytopenia caused by current disease or treatment also have menorrhagia (4). Some studies have indicated that the incidence of women presenting to a physician complaining of menorrhagia who have a Reprint requests to: Alicia Armstrong, MD, National Institutes of Health, Reproductive Biology and Medicine Branch, Rm. 1E-3140 CRC Bldg. 10, 10 Center Drive, Besthesda, MD 20892. armstroa@mail.nih.gov. The authors have disclosed that they have no financial relation ships with or interests in any commercial companies pertaining to this educational activity.The authors have disclosed that GnRH agonists (Lupron) has not been approved by the U.S. Food and Drug Administration for use in the treatment of menses supression in patients with thrombacytompenia. Please consult product labeling for the approved usage of this drug.Lippincott Continuing Medical Education Institute, Inc. has identified and resolved all faculty conflicts of interest regarding this educational activity. HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript coexisting inherited coagulation disorder is 17% to 20% (5,6). Uterine bleeding in this population can cause significant morbidity and require inpatient treatment and transfusion.Thrombocytopenia in reproductive age women can result from a number of causes: a decrease in platelet production, an increase in the destruction of platelets, and iatrogenic effects of medications. Patients with leukemia, myelodysplastic syndrome, aplastic anemia, liver failure, or hereditary syndromes may have thrombocytopen...

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High incidence of thromboembolism in patients with central nervous system lymphoma

Cited by 84 publications

References 15 publications

Analysis of incidence of thromboembolic complications in patients with chronic lymphoproliferative diseases

Analysis of incidence of thromboembolic complications in patients with chronic lymphoproliferative diseases

Clinical Reasoning: Vanishing tumor

Therapeutic Amenorrhea in Patients at Risk for Thrombocytopenia

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