Immune Activation and Inflammatory Biomarkers as Predictors of Venous Thromboembolism in Lymphoma Patients

Abstract Background: Lymphomas are characterized by inflammatory soluble mediators that can trigger the development of venous thromboembolism (VTE). However, data on the relationship between specific immune dysregulation and VTE occurrence in lymphoma are scarce. The study aimed to assess the association between inflammatory markers and the risk of VTE development in lymphoma patients.Methods: The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase (LDH), total protein (TP), and albumin were assessed in 706 patients with newly diagnosed or relapsed lymphoma. Data were collected for all VTE events, while the diagnosis of VTE was set objectively based on radiographic studies. ROC (receiver operating characteristic) curve analysis was used to define the optimal cutoff values for predicting VTE.Results: The majority of patients were diagnosed with aggressive non-Hodgkin lymphoma (58.8%) and had advanced disease (59.9%). Sixty-nine patients (9.8%) developed VTE. The NLR, PLR, ESR, CRP, and LDH were significantly higher in lymphoma patients with VTE, whereas the TP and albumin were significantly lower. In the univariate regression analysis, the NLR, PLR, TP, albumin, LDH, and CRP were prognostic factors for VTE development. In the multivariate regression model, the NLR and CRP were independent prognostic factors for VTE development. ROC curve analysis demonstrated acceptable specificity and sensitivity of the NLR, PLR, and CRP for predicting VTE. Conclusion: Inflammatory dysregulation plays an important role in VTE development in patients with lymphoma. Widely accessible, simple inflammatory parameters can classify lymphoma patients at risk of VTE development.