Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy
Abstract Background The Khorana score (KS) has not been well studied in East Asian cancer patients, who have different genetic backgrounds for inherited thrombophilia, body metabolism, and cancer epidemiology. Methods By using the Common Data Model, we retrospectively collected deidentified data fro...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-023-00505-3 |
| _version_ | 1797806598689652736 |
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| author | Hyerim Ha Yeh-Hee Ko Kwangsoo Kim Junshik Hong Gyeong-Won Lee Seong Hyun Jeong Soo-Mee Bang Sung-Soo Yoon |
| author_facet | Hyerim Ha Yeh-Hee Ko Kwangsoo Kim Junshik Hong Gyeong-Won Lee Seong Hyun Jeong Soo-Mee Bang Sung-Soo Yoon |
| author_sort | Hyerim Ha |
| collection | DOAJ |
| description | Abstract Background The Khorana score (KS) has not been well studied in East Asian cancer patients, who have different genetic backgrounds for inherited thrombophilia, body metabolism, and cancer epidemiology. Methods By using the Common Data Model, we retrospectively collected deidentified data from 11,714 consecutive newly diagnosed cancer patients who underwent first-line chemotherapy from December 2015 to December 2021 at a single institution in Korea, and we applied the KS for cancer-associated thrombosis (CAT) prediction. Age at diagnosis, sex, and use of highly thrombogenic chemotherapeutics were additionally investigated as potential risk factors for CAT development. Results By 6 months after chemotherapy initiation, 207 patients (1.77%) experienced CAT. Only 0.4% had a body mass index (BMI) ≥ 35 kg/m2 and changing the cutoff to 25 kg/m2 improved the prediction of CAT. Age ≥ 65 years and the use of highly thrombogenic chemotherapeutics were independently associated with CAT development. KS values of 1 ~ 2 and ≥ 3 accounted for 52.3% and 7.6% of all patients, respectively, and the incidence of CAT in these groups was 2.16% and 4.16%, respectively, suggesting a lower incidence of CAT in the study population than in Westerners. The KS component regarding the site of cancer showed a good association with CAT development but needed some improvement. Conclusion The KS was partially validated to predict CAT in Korean cancer patients undergoing modern chemotherapy. Modifying the BMI cutoff, adding other risk variables, and refining the use of cancer-site data for CAT risk prediction may improve the performance of the KS for CAT prediction in East Asian patients. |
| first_indexed | 2024-03-13T06:09:42Z |
| format | Article |
| id | doaj.art-c0aeda4cc8284e46aa27459a1205e054 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-03-13T06:09:42Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-c0aeda4cc8284e46aa27459a1205e0542023-06-11T11:22:57ZengBMCThrombosis Journal1477-95602023-06-012111810.1186/s12959-023-00505-3Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapyHyerim Ha0Yeh-Hee Ko1Kwangsoo Kim2Junshik Hong3Gyeong-Won Lee4Seong Hyun Jeong5Soo-Mee Bang6Sung-Soo Yoon7Department of Internal Medicine, Inha University College of Medicine, Inha University HospitalDepartment of Applied Statistics, Yonsei UniversityTransdisciplinary Department of Medicine & Advanced Technology, Department of Medicine, College of Medicine, Seoul National University Hospital, Seoul National UniversityDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of MedicineDepartment of Hematology-Oncology, Ajou University School of MedicineDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul National Bundang HospitalDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of MedicineAbstract Background The Khorana score (KS) has not been well studied in East Asian cancer patients, who have different genetic backgrounds for inherited thrombophilia, body metabolism, and cancer epidemiology. Methods By using the Common Data Model, we retrospectively collected deidentified data from 11,714 consecutive newly diagnosed cancer patients who underwent first-line chemotherapy from December 2015 to December 2021 at a single institution in Korea, and we applied the KS for cancer-associated thrombosis (CAT) prediction. Age at diagnosis, sex, and use of highly thrombogenic chemotherapeutics were additionally investigated as potential risk factors for CAT development. Results By 6 months after chemotherapy initiation, 207 patients (1.77%) experienced CAT. Only 0.4% had a body mass index (BMI) ≥ 35 kg/m2 and changing the cutoff to 25 kg/m2 improved the prediction of CAT. Age ≥ 65 years and the use of highly thrombogenic chemotherapeutics were independently associated with CAT development. KS values of 1 ~ 2 and ≥ 3 accounted for 52.3% and 7.6% of all patients, respectively, and the incidence of CAT in these groups was 2.16% and 4.16%, respectively, suggesting a lower incidence of CAT in the study population than in Westerners. The KS component regarding the site of cancer showed a good association with CAT development but needed some improvement. Conclusion The KS was partially validated to predict CAT in Korean cancer patients undergoing modern chemotherapy. Modifying the BMI cutoff, adding other risk variables, and refining the use of cancer-site data for CAT risk prediction may improve the performance of the KS for CAT prediction in East Asian patients.https://doi.org/10.1186/s12959-023-00505-3Khorana scoreCancer-associated thrombosisVenous thrombosisAsian |
| spellingShingle | Hyerim Ha Yeh-Hee Ko Kwangsoo Kim Junshik Hong Gyeong-Won Lee Seong Hyun Jeong Soo-Mee Bang Sung-Soo Yoon Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy Thrombosis Journal Khorana score Cancer-associated thrombosis Venous thrombosis Asian |
| title | Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy |
| title_full | Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy |
| title_fullStr | Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy |
| title_full_unstemmed | Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy |
| title_short | Application of the Khorana score for cancer-associated thrombosis prediction in patients of East Asian ethnicity undergoing ambulatory chemotherapy |
| title_sort | application of the khorana score for cancer associated thrombosis prediction in patients of east asian ethnicity undergoing ambulatory chemotherapy |
| topic | Khorana score Cancer-associated thrombosis Venous thrombosis Asian |
| url | https://doi.org/10.1186/s12959-023-00505-3 |
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