How to Identify High-Risk Lymphoma Patients for Catheter-Related Thrombosis: A Lymphoma-Specific Crt Risk Prediction Model

Abstract

Background: Lymphoma patients have a considerable risk of developing catheter-related thrombosis (CRT), which may affect their expected treatment and quality of life. The high occurrence of CRT events is a major unmet challenge in the clinical management of lymphoma. In this study, we aim to develop a clinically based risk model to estimate the risk of CRT in lymphoma patients.MethodsAll lymphoma inpatients undergoing catheterization between June 2012 and December 2022 at the National Cancer Center were retrospectively enrolled. Data including potential clinical predictors were obtained from hospital records. The lymphoma-specific CRT risk prediction model was generated based on a multivariate Cox regression analysis to identify potential predictors associated with CRT. The performance of the CRT risk prediction model was evaluated for discrimination, calibration, and decision curve analysis.ResultsWe analyzed the data of 537 lymphoma patients who underwent CVC insertion and developed a nomogram to predict their risk of CRT. A total of 41 patients underwent CRT. The risk factors for CRT in this cohort were BMI≥24 kg/m2 (3.79 [95% CI, 1.54-9.34]), VTE history (4.10 [95% CI, 2.09-8.03]), B symptoms (11.29 [95% CI, 5.07-25.13]), Hb<100 g/L (3.93 [95% CI, 1.69-9.07]) and PICC insertion (1.79 [95% CI, 0.78-4.16]). The model presented reliable calibration and discrimination, with a concordance index of 0.877 and a well-fitted calibration curve, indicating its clinical usefulness. A cutoff value of 11.14 was determined to predict CRT via the risk model.ConclusionsThe lymphoma-specific CRT risk prediction model is based on lymphoma clinical features and provides a more appropriate prediction model for assessing the risk of CRT in lymphoma patients.

Note:
Funding Declaration: This research was funded by the program of Beijing Hope Run Special Fund of Cancer Foundation of China (LC2020A17) and the CAMS Innovation Fund for Medical Sciences (CIFMS) (supported by the Special Research Fund for Central Universities, Peking Union Medical College,2022-I2M-C&T-B-069).

Conflicts of Interest: None

Ethical Approval: The current study was conducted under the Declaration of Helsinki, and ethnic approval was obtained from the Ethics Committee of the National Cancer Center. All patients signed a written informed consent form.

Keywords: catheter-related thrombosis, thrombosis, Venous thromboembolism, lymphoma, prediction model, nomogram