Incidence and risk factors of venous thromboembolism in patients with acute Leukemia: A systematic review and meta-analysis

Abstract

Introduction

Currently, no systematic review has been published regarding the incidence and risk factors of venous thromboembolism (VTE) in patients with acute leukemia. This study was implemented to identify the incidence and risk factors of VTE in patients with acute leukemia, aiming to offer guidance for corresponding clinical diagnosis and treatment.

Materials and methods

Studies in PubMed, Cochrane Library, Embase, and Web of Science were fully searched from database to January 2024. The risk of bias was assessed using NOS scale. Data analysis was performed with STATA 15.1.

Results

Twenty-two studies covering 53,433 samples were included. The overall incidence of VTE in patients with acute leukemia was 9 % (95 % CI: 0.07–0.12; P < 0.01). Older age in children (OR=2.21; 95 % CI: 1.40–3.49; P < 0.001), older age in adults (OR=2.05; 95 % CI: 1.02–4.10; P = 0.044), non-B cell subtype in acute lymphoblastic leukemia (ALL) (OR=1.85; 95 % CI: 1.43–2.39; P < 0.001) were risk factors for VTE in patients with acute leukemia, while Hispanic ethnicity was associated with a lower risk of VTE (OR=0.81; 95 % CI: 0.67–0.99; P = 0.040). Subgroup analysis results revealed that, in patients with acute myeloid leukemia, male gender was associated with a lower risk of VTE (OR=0.83; 95 % CI: 0.70–0.99; P = 0.039); in patients with ALL, older age in adults (OR=4.41; 95 % CI: 2.25–8.66; P < 0.001) and T-cell subtype (OR=1.82; 95 % CI: 1.39–2.37; P < 0.001) was a risk factor, non-White was associated with a lower risk of VTE (OR=0.69; 95 % CI: 0.54–0.89; P = 0.004).

Conclusion

The overall incidence of VTE was high in patients with acute leukemia. Older age and T-cell phenotype were risk factors, while Hispanic ethnicity was associated with a lower risk of VTE. This suggests more attention should be paid to high-risk groups in clinical practice.