PB1420 - Evaluation of Khorana, ThroLy and HL-ThroLy scores for the prediction of risk of venous thromboembolic events in Hodgkin lymphoma: A 5-year retrospective analysis.

Background:

Background: The rate of venous thromboembolism (VTE) in Hodgkin lymphoma (HL) ranges from 0.7-20%. In order to guide thromboprophylaxis, lymphoma-specific thrombotic risk scores (TRS) have been reported including Thrombosis Lymphoma (ThroLy) and the HL-specific HL-ThroLy.

Aims:

Aims: We aimed to validate ThroLy and HL-ThroLy in HL, and evaluate their performance against the Khorana risk score (KS).

Methods:

Methods: Retrospective, unicentric study of patients with HL undergoing first line treatment (2018-2022). The predictive performance of TRS over the initial 6 months was assessed using ROC curve analysis. Kaplan-Meier was used for cumulative VTE events and overall survival (OS) curves.

Results:

Results: We included 234 patients, 54% male, with a median age of 38.5 years. Most (98.3%) didn't receive thromboprophylaxis. Thirty-three (14.1%) experienced VTE, a third related to central venous catheters. Cumulative VTE rates for TRS by risk-group were for Throly: Low: 3/133pts(2.3%), intermediate: 19/83(22.9%), and high: 11/18(61.1%); for HL-Throly: Low: 0/70pts, intermediate: 3/69pts(4.3%), and high: 30/91(33.0%); and for KS: intermediate: 18/170pts(10.6%), and high: 15/64(23.4%). TRS detected patients with low ( < 5%) thrombotic risk in 133(56.8%) patients by Throly, 143(61.1%) by HL-Throly, and none by KS (Table 1). The AUC by ROC at 6 months was 85.6%, 86.1%, and 67.1% respectively (Figure 1). VTE was associated with lower OS (median 31 months vs not reached) after adjusting for advanced stage or bulky disease (p < 0.0001).

Conclusion(s):

Conclusions: Throly and HL-ThroLy represent an improvement for VTE-risk assessment in HL with more than half the patients falling into the low thrombotic-risk group, thus avoiding anticoagulation. HL-ThroLy, which constitutes a simple risk score, best detects individuals at very high thrombotic risk.