Risk factors associated with venous thromboembolism and impact on survival in the elderly US population with chronic myeloid leukemia

Risk factors for venous thromboembolism (VTE) and survival is not known in elderly patients with chronic myeloid leukemia (CML). To examine risk factors for VTE and survival in elderly patients with CML. We used the United States Surveillance, Epidemiology, and End Results and Medicare database for CML patients ≥65 years. VTE was defined as deep vein thrombosis or pulmonary embolism. Logistic regression was used to examine the risk factors for VTE and Cox proportional regression was used to evaluate the effect of VTE on mortality and survival. Among 5535 elderly patients diagnosed with CML (2000-2015), 11.4% of had a diagnosis of VTE. Patients <75 years of age and females had a higher risk of VTE, and Asian patients had a lower risk of VTE. Comorbidities associated with VTE were anemia (adjusted odds ratio [ORa] = 1.89, 95% confidence interval [CI], 1.48-2.41), hypertension (ORa = 1.88, 95% CI, 1.43-2.49), heart failure (ORa = 1.70, 95% CI, 1.40-2.07), obesity (ORa = 1.44, 95% CI, 1.15-1.80) and kidney disease (ORa = 1.32, 95% CI, 1.09-1.59). VTE was a predictor of death in patients <75 years of age but not in the overall population. Data were stratified into 3 treatment groups: tyrosine kinase inhibitors (TKIs), chemotherapy and no treatment (no TKI and no chemotherapy) groups. Among 3085 elderly patients with CML (2007-2015), risk of death was higher in patients who received chemotherapy. Overall survival was longer in patients who received TKI (P < .001); however, VTE was a predictor of death in the TKI group. Our findings may help to determine the VTE risk profile and impact on survival in elderly patients with CML.