Câncer/Oncologia/Tumor

Tromboembolismo venoso (TEV) é uma causa comum de morbidade e mortalidade entre pacientes com gliomas malignos. Para investigar a patogênese de TEV e facilitar estratégias profiláticas a serem atingidas, pesquisadores de Johns Hopkins Medical Institutions, em Baltimore, realizaram um estudo, publicado recentemente na revista Cancer, com o objetivo de caracterizar os fatores de risco de TEV em pacientes com gliomas malignos.

Foi conduzida uma análise retrospectiva de 130 pacientes adultos com glioma que receberam terapia primária no Hospital Johns Hopkins (Baltimore, MD) entre 1991 a 2001. TEV sintomático foi confirmado por ensaio radiológico objetivo. A associação entre características clínicas e laboratoriais e TEV foi avaliada por meio de testes estatísticos paramétricos e não-paramétricos e análise de sobrevivência.

Vinte e oito pacientes (21,5%) desenvolveram TEV a uma mediana de 4,8 meses após o diagnóstico (amplitude interquartil: 2,1-3,2). Os pacientes com tumores ? 5 cm foram mais prováveis de desenvolver TEV do que aqueles com tumores pequenos (razão de risco = 2,2; P = 0,04). Para cada ano adicional na idade, as razões de risco para trombose aumentaram de 3% (P = 0,011). Quando estratificado pelo grupo sangüíneo ABO, as razões de risco para trombose foram de 2,7 e 9,4 para pacientes com grupos sangüíneos A (P = 0,045) e AB (P ? 0,0001), respectivamente, comparados com pacientes do grupo O. Nenhuma associação foi observada entre TEV e outras características do paciente analisadas.

Os autores concluíram que a idade do paciente, o tamanho do tumor e particularmente o grupo sangüíneo ABO são fatores de risco para tromboembolismo venoso entre pacientes com gliomas malignos. Afirmaram ainda que estes achados podem facilitar o desenvolvimento de um escore de risco para trombose, que permitirá aos médicos individualizar os regimes de profilaxia de tromboembolismo venoso.

ABO blood group is a potent risk factor for venous thromboembolism in patients with malignant gliomas - Cancer 2004; 100(8): 1717-1723.

Cancer Volume 100, Issue 8 , Pages 1717 - 1723 Published Online: 11 Mar 2004 Copyright © 2004 American Cancer Society Save Title to My Profile Set E-Mail Alert

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Original Article ABO blood group is a potent risk factor for venous thromboembolism in patients with malignant gliomas Michael B. Streiff, M.D. 1, Jodi Segal, M.D. 1, Stuart A. Grossman, M.D. 1 3, Thomas S. Kickler, M.D. 1 2, Edward G. Weir, M.D. 2 * 1Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland 2Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 3Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, Maryland email: Edward G. Weir (eweir@jhmi.edu) *Correspondence to Edward G. Weir, Department of Pathology, The Johns Hopkins Medical Institutions, Weinberg Building, Room 2327, 401 N. Broadway, Baltimore, MD 21231 Fax: (410) 502-1493 Keywords ABO blood group • venous thromboembolism • malignant gliomas • risk factors Abstract BACKGROUND Venous thromboembolism (VTE) is a common cause of morbidity and mortality among patients with malignant gliomas. To investigate the pathogenesis of VTE and facilitate targeted prophylaxis strategies, the authors aimed to characterize VTE risk factors in these patients. METHODS The authors conducted a retrospective chart review of 130 adult patients with glioma who received their primary therapy at the Johns Hopkins Hospital (Baltimore, MD) between 1991 and 2001. Symptomatic VTE was confirmed by objective radiologic testing. The association between clinical and laboratory characteristics and VTE was assessed using parametric and nonparametric statistical tests and survival analysis. RESULTS VTE developed in 28 patients (21.5%) at a median of 4.8 months after diagnosis (interquartile range, 2.1-13.2). Patients with tumors > 5 cm were more likely to develop VTE than patients with smaller tumors (hazard ratio = 2.2; P = 0.04). For every year increase in age, the hazard ratios for thrombosis increased by 3% (P = 0.011). When stratified by ABO blood group, the hazard ratios for thrombosis were 2.7 and 9.4 for patients with blood groups A (P = 0.045) and AB (P < 0.0001), respectively, compared with patients with blood group O. No association was observed between VTE and the other patient characteristics analyzed. CONCLUSIONS Patient age, tumor size, and particularly ABO blood group are risk factors for VTE among patients with malignant gliomas. These findings may facilitate the development of a thrombosis risk score that will allow physicians to individualize VTE prophylaxis regimens. Cancer 2004. © 2004 American Cancer Society.