Risk factors and risk prediction model for venous thromboembolism in patients with diffuse large B-cell lymphoma
Shi Yufan
Xing Shuangshuang
Pu Yiqin
Hu Yan
Qiu Shuoren
Wang Wenwen
He Hongfang
Li Yue
Abstract：Objective To analyze the risk factors for venous thromboembolism(VTE)in patients with diffuse large B-cell lym-phoma(DLBCL)and to construct a risk prediction model to inform clinical decisionmaking.Methods A total of 206 DLBCL patients treated between July 2022 and June 2024 at a hospital in Nanjing were retrospectively assigned to a VTE group(n=35)and a nonVTE group(n=171)according to whether they developed VTE during treatment.Clinical data were extracted from electronic medical records before analyses.Multivariate logistic regression was used to identify independent influence fac-tors for VTE.A nomogram was then developed and validated.The predictive performance of the nomogram was assessed by receiver operating characteristic(ROC)curve analysis.Results Compared with the nonVTE group,patients in the VTE group were more frequently ≥60 years old,had diabetes,presented with clinical stage Ⅲ-Ⅳ disease,had Eastern Coopera-tive Oncology Group performance status(ECOG PS)≥3,underwent central venous catheterization,and failed to achieve com-plete remission(nonCR)after 3-4 chemotherapy cycles;they also exhibited higher white blood cell counts,lactate dehydro-genase,and D-dimer levels,and lower hemoglobin levels,with statistically significant differences(all P＜0.05).Multivariate analysis revealed that age≥60 years(OR=2.401,95％CI:1.509-3.821),comorbid with diabetes(OR=2.465,95％CI:1.604-3.786),ECOG PS≥3(OR=2.342,95％CI:1.576-3.480),central venous catheterization(OR=2.866,95％CI:1.925-4.267),nonCR after 3-4 chemotherapy cycles(OR=3.540,95％CI:2.277-5.501),and elevated D-dimer(OR=3.728,95％CI:2.055-6.766)were independent risk factor of VTE(P＜0.05).The nomogram incorporating these factors demonstrated a concordance index(Cindex)of 0.884(95％CI:0.831-0.937).ROC analysis showed an area under the curve(AUC)of 0.875(95％CI:0.822-0.928)for predicting VTE among patients with DLBCL,with a sensitivity of 92.59％and a specificity of 67.49％.Conclusion In DLBCL patients,age ≥60 years,comorbid with diabetes,ECOG PS ≥3,central ve-nous catheterization,nonCR after 3-4 chemotherapy cycles,and elevated D-dimer are risk factors for VTE.The nomogram model constructed based on these variables has a high predictive value for VTE in DLBCL patients.
Keywords：Diffuse large B-cell lymphomaVenous thromboembolismRisk factorsNomogramPrediction model
Publication Date：2025-05-20
Online Publishing Date：2025-09-04(First online date of this platform, not the publication date of the document)
Pages：6( 13-18 )