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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB0947 - The Risk of Venous Thromboembolism in Primary Central Nervous System Lymphoma: A Systematic Review

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Presenting Author(s)

    • Adam Suleman, MD

      Hematology Resident
      University of Toronto
      Toronto, Ontario, Canada

      • Co-Author(s)

    • RW

      Rachel Wine

      Medical Student
      University of Toronto
      Toronto, Ontario, Canada

    • Marc Carrier, MD

      MD, MSc
      Ottawa Hospital Research Institute, Ottawa, ON, Canada
      Ottawa, Ontario, Canada

    • LH

      Lisa Hicks

      Hematologist
      St. Michael's Hospital
      Toronto, Ontario, Canada

    Background: Primary central nervous system lymphoma (PCNSL) is a rare extranodal lymphoma localized to the central nervous system. Small single-centre studies have suggested that patients with PCNSL may be at high risk of venous thromboembolism (VTE). Determining the true risk of VTE in patients with PCNSL will help inform whether these patients should be on VTE prophylaxis.

    Aims: To estimate the risk of VTE in patients with PCNSL.

    Methods: A systematic review was conducted using preferred reporting items (PRISMA) guidelines. MEDLINE, Embase and CINAHL were searched from 1990-2022. Prospective and retrospective observational studies were included, as well as clinical trials. Editorials and conference abstracts were excluded. The primary efficacy outcome was VTE, and the primary safety outcome was major bleeding as defined by the individual studies.

    Results: After screening 883 studies, 46 studies (3688 patients) with PCNSL were included. Median age was 62.4 across all studies. Five studies explored the use of thromboprophylaxis (ASA or anticoagulation (N=1) and low molecular wight heparin (N=4). Overall, 420 patients developed VTE (11.4%), including 17 fatal pulmonary embolism events (0.62%). Two studies that reported on VTE prophylaxis representing 77 patients identified 8 breakthrough VTE events (10.4%). A majority of studies (N=34; 74.5%) did not report major bleeding complications. Among studies reporting on bleeding, 174 major bleeding (7.4%) events were reported out of 2361 patients, 3 of which were attributed to thromboprophylaxis. A full meta-analysis is underway and will be completed by the time of the ISTH Congress.

    Conclusion(s): Patients with PCNSL seem to be at high risk of both VTE and bleeding complications. Future clinical trials in this population should routinely collect data on incidence of VTE and bleeding to help clinician assess risk-benefit ratio of thromboprophylaxis in this high risk patient population.