Prognostic models of thrombosis in lymphoma patients

Postgraduate Thesis uoadl:3350089 1 Read counter

Κατεύθυνση Θρόμβωση-Αιμορραγία-Ιατρική των μεταγγίσεων
Library of the School of Health Sciences
Deposit date:
Kontitsi Kyriaki
Supervisors info:
Ευάγγελος Τέρπος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Θεόδωρος Βασιλακόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαριάννα Πολίτου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Προγνωστικά μοντέλα θρόμβωσης σε ασθενείς με λέμφωμα
Translated title:
Prognostic models of thrombosis in lymphoma patients
Lymphoma is a heterogeneous group of cancers of lymphocytes with
divercity in pathology and clinical manifestations.
Lymphoma patients have an increased incidence of thromboembolism, which
varies from 5% to 59%. It can be presented as venous thromboembolism, and
less commonly as arterial thromboembolism or thrombotic microangiopathy.
A prothrombotic state is developed in lymphoma microenvirnment, due to
underlying immunothrombosis that aims to lymphoma survival and growth.
Cytokine production from neoplastic cells leads on endothelial injury and
activation, as well as recruitment of immune cells, which produce
prothrombotic factors, such as TF and phosphatidylserine. Chemotherapy and
infections are factors that enhance the underlying prothrombotic condition,
contributing to the incidence of thrombosis.
Current guidelines about thromboprophylaxis in cancer patients do not take
into account the specific lymphoma’s characteristics and their contribution to
thromboembolic events. A literature review had been done in this project, in
order to assess the incidence and risk factors of thromboembolic events in
lymphoma patients. High- grade ΝΗL, especially PCNSL and PMBCL,
advanced disease stage, bulky disease and mediastinal involvement were
identified as risk factors for thromboembolic events. As patient- related risk
factors were considered the reduced performance status (ECOG >/=2) and
history of VTE/ ATE. Age and elevated Body mass index do not related with
thrombosis with a significant difference. These results are compatible with
prediction models of thrombosis ThroLy and Tic- Lympho. The modification
of these models may improve the thromboembolism prediction in lymphoma
patients. The contribution of platelet activation biomarkers, such as MPV, Pselectin
and PLR could be studied in order to evaluate their usefulness.
The purpose of this work is to analyse the pathophysiology of prothrombotic
state in lymphoma patients, refer to existed prediction models of thrombosis
and identification of high risk patients for development of thrombosis.
Conduction of more clinical studies and establishment of an accurate
prediction model is necessary, in order to achieve personalized treatment and
appropriate use of thromboprophylaxis in high risk patients.
Main subject category:
Health Sciences
Lymphoma, Thromboembolism, Prognostic model
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