Risk of thrombocytopenia in selected cancer therapies for hematologic malignancies
| Cancer type . | VTE incidence rate per 100 PY . | Selected systemic therapy . | Thrombocytopenia (any grade)** . | Severe thrombocytopenia (grades 3-4)** . | Reference . |
|---|---|---|---|---|---|
| NHL | 6.3/100 PY | R-CHOP | / | Every 14 days: 9% Every 21 days: 5% | Cunningham et al, Lancet 2013 |
| CLL | 4-year cumulative incidence: 3.1% | FCR/R-bendamustin | 14.9% | 8.4% | Eichhorst et al, NEJM 2023 |
| venetoclax-rituximab | 7.1% | 3.4% | |||
| venetoclax-obinutuzumab | 17.5% | 14.9% | |||
| venetoclax-obinutuzumab-brutinib | 21.7% | 11.3% | |||
| HL | 5.1/100 PY | ABVD | / | 2% | Viviani et al, NEJM 2011 |
| BEACOPP (stage IIB, III, or IV and high risk) | 8% | ||||
| A+AVD | <5% | 0.15% | Ansell et al, NEJM 2022 | ||
| MM | 6.7/100 PY | D-VRd RvD | 48.4% 34.3% | 29.1% 17.3% | Sonneveld et al, NEJM 2024 |
| ASCT | / | 82.7% | Richardson et al, NEJM 2022 |
| Cancer type . | VTE incidence rate per 100 PY . | Selected systemic therapy . | Thrombocytopenia (any grade)** . | Severe thrombocytopenia (grades 3-4)** . | Reference . |
|---|---|---|---|---|---|
| NHL | 6.3/100 PY | R-CHOP | / | Every 14 days: 9% Every 21 days: 5% | Cunningham et al, Lancet 2013 |
| CLL | 4-year cumulative incidence: 3.1% | FCR/R-bendamustin | 14.9% | 8.4% | Eichhorst et al, NEJM 2023 |
| venetoclax-rituximab | 7.1% | 3.4% | |||
| venetoclax-obinutuzumab | 17.5% | 14.9% | |||
| venetoclax-obinutuzumab-brutinib | 21.7% | 11.3% | |||
| HL | 5.1/100 PY | ABVD | / | 2% | Viviani et al, NEJM 2011 |
| BEACOPP (stage IIB, III, or IV and high risk) | 8% | ||||
| A+AVD | <5% | 0.15% | Ansell et al, NEJM 2022 | ||
| MM | 6.7/100 PY | D-VRd RvD | 48.4% 34.3% | 29.1% 17.3% | Sonneveld et al, NEJM 2024 |
| ASCT | / | 82.7% | Richardson et al, NEJM 2022 |
Contemporary VTE estimates within 1 year after cancer diagnosis based on Danish population-level data.
Thrombocytopenia categorized according to the Common Terminology Criteria for Adverse Events of the National Cancer Institute: grade 1: 75-150 G/L, grade 2: 50-75 G/L, grade 3: 25-50 G/L, grade 4: < 25 G/L.
Data adapted with permission from Mulder et al12 and Frere et al.52
ABVD, regimen consisting of doxorubicin, bleomycin, vinblastine and dacarbazine; ASCT, autologous stem cell transplantation; BEACOPP, regimen consisting of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone; CLL, chronic lymphocytic leukemia; D-VRd, Daratumumab, Bortezomib, Lenalidomide, Dexamethasone; FCR, regimen consisting of fludarabine, cyclophosphamide and rituximab; HL, Hodgkin's lymphoma; MM, multiple myeloma; NHL, non-Hodgkin's lymphoma; PY, patient-years; R-CHOP, regimen consisting of cyclophosphamide, doxorubicin, prednisone, rituximab and vincristine; VRd, Bortezomib, Lenalidomide, Dexamethasone.