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Cancers
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Advance Research in Thrombosis and Hematologic Malignancies
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Advance Research in Thrombosis and Hematologic Malignancies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 10369

Special Issue Editor

Prof. Dr. Maria Ilaria Del Principe

E-Mail Website
Guest Editor
Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy
Interests: acute lymphoblastic leukemia; acute myeloid leukemia; flow cytometry; complication

Special Issue Information

Dear Colleagues,

Thrombosis is one of the most frequent complications in cancer and the second leading cause of death among patients with malignant diseases. The risk of thrombosis increases seven-fold in cancer patients compared with the general population. However, the risk of thrombosis in patients with hematologic malignancies is considered to be lower than in solid tumors, and a significant amount of attention is directed toward bleeding and infectious complications due to thrombocytopenia and neutropenia. Recent studies indicate that the risk of thrombosis in hematologic patients may be similar to or even higher than in those with solid neoplasms. Among hematologic malignancies, the incidence of venous thromboembolism is better known in myeloma (5%), non-Hodgkin lymphoma (4.8%), and Hodgkin disease (4.6%), while information on acute leukemia is sparse. This Special Issue focuses on the current knowledge about the pathogenesis, incidence, risk factors, and management of thrombotic events in patients with hematologic malignancies.

Prof. Dr. Maria Ilaria Del Principe
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (5 papers)

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Research

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9 pages, 263 KiB  
Article
Arterial Thrombosis in Patients with Acute Myeloid Leukemia: Incidence and Risk Factors
by Mirjana Mitrovic, Nikola Pantic, Nikica Sabljic, Zoran Bukumiric, Marijana Virijevic, Zlatko Pravdic, Mirjana Cvetkovic, Jovan Rajic, Jelena Bodrozic, Violeta Milosevic, Milena Todorovic-Balint, Ana Vidovic, Nada Suvajdzic-Vukovic and Darko Antic
Cancers 2023, 15(11), 3060; https://doi.org/10.3390/cancers15113060 - 05 Jun 2023
Cited by 2 | Viewed by 1068
Abstract
Background: Patients with hematological malignancies have an increased risk of arterial thrombotic events (ATEs) after diagnosis, compared to matched controls without cancer. However, data about incidence and risk factors for ATE development in patients with acute myeloid leukemia (AML) are missing. Aim: The [...] Read more.
Background: Patients with hematological malignancies have an increased risk of arterial thrombotic events (ATEs) after diagnosis, compared to matched controls without cancer. However, data about incidence and risk factors for ATE development in patients with acute myeloid leukemia (AML) are missing. Aim: The objectives of this study were to determine the incidence of ATE in non-promyelocytic-AML patients and to define the potential risk factors for ATE development. Methods: We conducted a retrospective cohort study of adult patients with newly diagnosed AML. The primary outcome was the occurrence of confirmed ATE, defined as myocardial infarction, stroke or critical limb ischemia. Results: Out of 626 eligible AML patients, 18 (2.9%) patients developed ATE in the median time of 3 (range: 0.23–6) months. Half of these patients died due to ATE complications. Five parameters were predictors of ATE: BMI > 30 (p = 0.000, odds ratio [OR] 20.488, 95% CI: 6.581–63.780), prior history of TE (p = 0.041, OR 4.233, 95% CI: 1.329–13.486), presence of comorbidities (p = 0.027, OR 5.318, 95% CI: 1.212–23.342), presence of cardiovascular comorbidities (p < 0.0001, OR 8.0168, 95% CI: 2.948–21.800) and cytogenetic risk score (p = 0.002, OR 2.113, 95% CI: 1.092–5.007). Conclusions: Our study showed that patients with AML are at increased risk of ATE. The risk was increased in patients with cardiovascular comorbidities, previous thrombosis, adverse cytogenetic risk as well as BMI > 30. Full article
(This article belongs to the Special Issue Advance Research in Thrombosis and Hematologic Malignancies)
12 pages, 1151 KiB  
Article
Predictors of Early Thrombotic Events in Adult Patients with Acute Myeloid Leukemia: A Real-World Experience
by Giovangiacinto Paterno, Raffaele Palmieri, Vittorio Forte, Valentina Del Prete, Carmelo Gurnari, Luca Guarnera, Flavia Mallegni, Maria Rosaria Pascale, Elisa Buzzatti, Valeria Mezzanotte, Ilaria Cerroni, Arianna Savi, Francesco Buccisano, Luca Maurillo, Adriano Venditti and Maria Ilaria Del Principe
Cancers 2022, 14(22), 5640; https://doi.org/10.3390/cancers14225640 - 17 Nov 2022
Cited by 7 | Viewed by 1320
Abstract
Information regarding the incidence and the prognostic impact of thrombotic events (TE) in non-promyelocytic acute myeloid leukemia (AML) is sparse. Although several risk factors associated with an increased risk of TE development have been recognized, we still lack universally approved guidelines for identification [...] Read more.
Information regarding the incidence and the prognostic impact of thrombotic events (TE) in non-promyelocytic acute myeloid leukemia (AML) is sparse. Although several risk factors associated with an increased risk of TE development have been recognized, we still lack universally approved guidelines for identification and management of these complications. We retrospectively analyzed 300 consecutive patients with newly diagnosed AML. Reporting the incidence of venous TE (VTE) and arterial TE (ATE) was the primary endpoint. Secondarily, we evaluated baseline patient- and disease-related characteristics with a possible influence of VTE-occurrence probability. Finally, we evaluated the impact of TE on survival. Overall, the VTE incidence was 12.3% and ATE incidence was 2.3%. We identified three independent predictors associated with early-VTE: comorbidities (p = 0.006), platelets count >50 × 109/L (p = 0.006), and a previous history of VTE (p = 0.003). Assigning 1 point to each variable, we observed an overall cumulative incidence of VTE of 18.4% in the high-risk group (≥2 points) versus 6.4% in the low-risk group (0–1 point), log-rank = 0.002. Overall, ATE, but not VTE, was associated with poor prognosis (p < 0.001). In conclusion, TE incidence in AML patients is not negligible. We proposed an early-VTE risk score that could be useful for a proper management of VTE prophylaxis. Full article
(This article belongs to the Special Issue Advance Research in Thrombosis and Hematologic Malignancies)
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15 pages, 1600 KiB  
Article
Venous Thromboembolism and Its Risk Factors in Children with Acute Lymphoblastic Leukemia in Israel: A Population-Based Study
by Shlomit Barzilai-Birenboim, Ronit Nirel, Nira Arad-Cohen, Galia Avrahami, Miri Ben Harush, Assaf Arie Barg, Bella Bielorai, Ronit Elhasid, Gil Gilad, Amos Toren, Sigal Weinreb, Shai Izraeli and Sarah Elitzur
Cancers 2020, 12(10), 2759; https://doi.org/10.3390/cancers12102759 - 25 Sep 2020
Cited by 9 | Viewed by 2511
Abstract
Venous thromboembolism (VTE) is a serious complication of acute lymphoblastic leukemia (ALL) therapy. The aim of this population-based study was to evaluate the rate, risk factors, and long-term sequelae of VTE in children treated for ALL. The cohort included 1191 children aged 1–19 [...] Read more.
Venous thromboembolism (VTE) is a serious complication of acute lymphoblastic leukemia (ALL) therapy. The aim of this population-based study was to evaluate the rate, risk factors, and long-term sequelae of VTE in children treated for ALL. The cohort included 1191 children aged 1–19 years diagnosed with ALL between 2003–2018, prospectively enrolled in two consecutive protocols: ALL-IC BFM 2002 and AIEOP-BFM ALL 2009. VTEs occurred in 89 patients (7.5%). Long-term sequelae were uncommon. By univariate analysis, we identified four significant risk factors for VTEs: Severe hypertriglyceridemia (p = 0.005), inherited thrombophilia (p < 0.001), age >10 years (p = 0.015), and high-risk ALL group (p = 0.039). In addition, the incidence of VTE was significantly higher in patients enrolled in AIEOP-BFM ALL 2009 than in those enrolled in ALL-IC BFM 2002 (p = 0.001). Severe VTE occurred in 24 children (2%), all of whom had at least one risk factor. Elevated triglyceride levels at diagnosis did not predict hypertriglyceridemia during therapy. In a multivariate analysis of 388 children, severe hypertriglyceridemia and inherited thrombophilia were independent risk factors for VTE. Routine evaluation for these risk factors in children treated for ALL may help identify candidates for intervention. Full article
(This article belongs to the Special Issue Advance Research in Thrombosis and Hematologic Malignancies)
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Review

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22 pages, 369 KiB  
Review
Monoclonal Gammopathy of Thrombotic Significance
by Vasiliki Gkalea, Despina Fotiou, Meletios Athanasios Dimopoulos and Efstathios Kastritis
Cancers 2023, 15(2), 480; https://doi.org/10.3390/cancers15020480 - 12 Jan 2023
Cited by 6 | Viewed by 2720
Abstract
The current review provides an overview of the thrombotic risk observed in patients with MG who do not otherwise require treatment. We discuss clinical and biomarker studies that highlight the heterogenous hemostatic profile observed in these patients and how knowledge has evolved over [...] Read more.
The current review provides an overview of the thrombotic risk observed in patients with MG who do not otherwise require treatment. We discuss clinical and biomarker studies that highlight the heterogenous hemostatic profile observed in these patients and how knowledge has evolved over the past 20 years. Biomarker studies suggest shared biologic features between multiple myeloma and monoclonal gammopathy of undetermined significance (MGUS), which involves both hypercoagulability and platelet activation. Hemostatic abnormalities identified in MGUS patients cannot be translated into clinical practice as they lack correlation to clinical events. The prothrombotic phenotype of MGUS patients has not been ascertained yet, but novel data on coagulation markers are promising. We also review rare conditions associated with the thrombogenic properties of the monoclonal protein that predispose to arterial, venous or microthrombotic events and demonstrate that the M-protein can be linked to clinically significant thrombotic events. Cryoglobulinemia, cryofibrinogenemia, cryo-crystaloglobulinemia and MG-related antiphospholipid syndrome are reviewed. We propose the new umbrella term “monoclonal gammopathy of thrombotic significance” (MGTS) to refer to significant, recurrent thrombotic events in patients with MGUS that provide a rationale for targeting the underlying plasma cell clone. Identifying MGUS patients at high risk for thrombotic events is currently a challenge. Full article
(This article belongs to the Special Issue Advance Research in Thrombosis and Hematologic Malignancies)
14 pages, 923 KiB  
Review
Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
by Angela Liu, Leonard Naymagon and Douglas Tremblay
Cancers 2023, 15(1), 11; https://doi.org/10.3390/cancers15010011 - 20 Dec 2022
Cited by 3 | Viewed by 2154
Abstract
Patients who develop splanchnic vein thrombosis (SVT) in the setting of a myeloproliferative neoplasm (MPN) are at risk for complications including portal hypertension, bleeding, thrombosis, and death. Prompt multidisciplinary treatment is thus necessary to prevent long-term sequelae. However, optimal management strategies are not [...] Read more.
Patients who develop splanchnic vein thrombosis (SVT) in the setting of a myeloproliferative neoplasm (MPN) are at risk for complications including portal hypertension, bleeding, thrombosis, and death. Prompt multidisciplinary treatment is thus necessary to prevent long-term sequelae. However, optimal management strategies are not well established due to a paucity of data. In this review, we very briefly discuss the epidemiology, pathophysiology, and prognosis of MPN-SVT and then more comprehensively explore treatment considerations of MPN-SVT, including anticoagulation, endovascular/surgical intervention, and cytoreductive therapy. We will also highlight current gaps in our knowledge of MPN-SVT and conclude by suggesting future directions to optimize the treatment of MPN-SVT and improve outcomes. Full article
(This article belongs to the Special Issue Advance Research in Thrombosis and Hematologic Malignancies)
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