A study published in Blood Coagulation and Fibrinolysis reveals demographic and individual characteristics that raise the risk of venous thromboembolism (VTE) in patients diagnosed with acute myeloid leukemia (AML). Specifically, whereas Black and White patients appear to have a similar risk for developing VTE, Asian patients appear to have a lower risk of the complication.

Although the relatively high risk of VTE is well-established in the AML setting, the demographic and clinical risk factors for the complication were previously unknown. For this study, researchers evaluated the relative risk of VTE, and VTE-related mortality, among elderly Black, White, and Asian patients with AML.

All data were obtained from the Surveillance, Epidemiology, and End Results-Medicare database and were dated from between 2000 and 2015. Additionally, all included patients were at least 65 years old.

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Overall, data from 1310 Asian patients with AML (no VTE, 1237; VTE, 73), 1362 Black patients (no VTE, 1180; VTE, 82), and 18,731 White patients (no VTE, 16,743; VTE, 1988) were included. White, Black, and Asian patients who experienced VTE had mean ages of 76, 75.7, and 74.8 years, respectively, and 71.1%, 71.1%, and 69.9% of patients survived less than 1 year.

Analysis showed that while there was no difference in VTE risk between Black and White patients, Asian patients had almost half the risk of VTE compared with White patients (hazard ratio, 0.54; 95% CI, 0.43-0.68).

Further analysis showed that, among White patients, risk factors for VTE included age less than 75 years, female sex, chemotherapy, and comorbidities such as hypertension, anemia, chronic kidney/lung disease, hyperlipidemia, heart failure, and obesity.

Among Black patients, risk factors included hyperlipidemia and heart failure; among Asian patients, age less than 75 years, female sex, chemotherapy, hypertension, and myocardial infarction. Across groups, central venous catheter placement raised the risk of VTE.

This large population-based study suggests differences in known risk factors for VTE in elderly white, black and Asian patients with AML,” the authors wrote in their report. “Further research is warranted to confirm these findings and to develop strategies for the prevention of VTE in a racially diverse population of elderly AML patients.”

Faiz AS, Guo S, Sridharan A, Lin Y, Philipp CS. Venous thromboembolism and acute myeloid leukemia: risk factors and mortality in elderly white, black and Asian patients. Blood Coagul Fibrinolysis. 2023;34(6):345-352. doi:10.1097/MBC.0000000000001226