PB0983 - Assessing Hypercoagulability and VTE Risk using Thromboelastography and Khorana Score in Women Receiving Chemotherapy for Breast and Gynecological Cancer

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

YT

Yousra Tera

Postdoc Research fellow
Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada
Mansoura, Ad Daqahliyah, Egypt

Co-Author(s)

KF

Karina Fainchtein

Undergraduate Student
Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada
Kingston, Ontario, Canada
Mazen Assar, MD

Professor
School of Baccalaureate Nursing, St Lawrence College, Kingston, Ontario, Canada
Kingston, Ontario, Canada
YJ

Yoon Jin Suh

Research Assistant
School of Baccalaureate Nursing, St Lawrence College, Kingston, Ontario, Canada
Kingston, Ontario, Canada
MK

Maria Karizhenskaia

Research Assistant
Queen's University
Kingston, Ontario, Canada
AA

Anita Agrawal

Assistant Professor
Department of Obstetrics and Gynecology, Queen’s University, Kingston, Ontario, Canada
Kingston, Ontario, Canada
Mm

Mihaela mates

Associate Professor
Department of Oncology, Queen’s University, Kingston, Ontario, Canada
Kingston, Ontario, Canada

Presenting Author(s)

Maha Othman, MD PhD

Professor
Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada,
Kingston, Ontario, Canada

Background: Venous thromboembolism (VTE) is a common occurrence in cancer. Thrombosis risk varies according to several cancer and patient-related factors. Chemotherapy increases this risk 9-fold. Current VTE risk assessment models such as the Khorana score and its modifications can identify patients at high risk when undergoing chemotherapy but have not been applied to all cancers and also have limitations.

Aims: To examine whether thromboelastography (TEG) can detect hypercoagulability in cancer patients undergoing chemotherapy and assess VTE risk in conjunction with the Khorana score.

Methods: A single-center, prospective, longitudinal, non-interventional study. 33 patients (17 breast, 11 endometrial, 5 ovarian cancer), with 26 postmenopausal and 7 metastatic diseases, who started chemotherapy, were evaluated to date. TEG was performed prior to and after chemotherapy cycles 1 and 2. TEG parameters R, K, α, MA, LY30, and CI were evaluated. One Way ANOVA was used to assess the difference between groups. Demographic, cancer, and lab data were examined including the Khorana score. Patients were followed for 6 months for any thrombotic events.

Results: Hypercoagulability was detected in samples 2 and 3 based on a reduction in R, K, and an increase in α angle, MA, and CI, but these changes were not statistically significant over time. 43- 71% of patients had hypercoagulable parameters in sample 2,3 (Table 1). Khorana score showed 6 patients were low risk, 19 were intermediate and 2 were high risk. The MA and CI showed a significant increase with the intermediate and high-risk Khorana scores when compared to the low-risk group (P=0.03, 0.04 respectively) (Table 2).

Conclusion(s): TEG can detect hypercoagulability after the 1st dose of chemotherapy, most prominently in MA, but the effect is diluted over time. TEG MA and CI can be useful in assessing VTE risk and may potentially be added to improve the Khorana scoring application.