{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:02:35Z","timestamp":1783393355061,"version":"3.54.6"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: A majority of patients included in risk assessment models (RAMs) developed to predict venous thromboembolic events (VTE) in lymphoma were non-Hodgkin lymphoma. Our study aims to evaluate the incidence and predictors of VTE, utilizing different RAMs, in patients with classic Hodgkin lymphoma (cHL) treated with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). Methods: Adult patients with cHL, treated and followed at our center, were included. Correlations between different variables, Khorana score, and thrombosis in lymphoma (ThroLy) RAMs with VTE were examined using Fisher\u2019s exact test and logistic regression analysis. Results: A total of 321 patients were included, with a median age of 29 (range: 18\u201383) years. Of them, 169 (52.6%) had advanced-stage disease. Combined modality treatment was given to 169 (52.6%) patients. A total of 52 (16.2%) patients had relapsed or refractory disease. VTE were reported in 15 (4.7%) patients and were mostly during the administration of first-line (n = 8, 53.3%), or salvage chemotherapy (n = 6, 40.0%). There was no correlation between a Khorana score &gt; 2 (p = 0.689) or ThroLy score &gt; 3 (p = 0.335) and VTE. Older age (p = 0.014) and relapsed or refractory disease (p = 0.003) significantly correlated with VTE. Conclusions: VTE are uncommon in cHL. The commonly used RAMs failed to predict VTE. However, older age and relapsed or refractory disease significantly increased this risk.<\/jats:p>","DOI":"10.3390\/jcm13020436","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T11:43:53Z","timestamp":1705059833000},"page":"436","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Application of Existing Risk Assessment Models (RAMS) to Predict the Occurrence of Venous Thromboembolic Events among Patients with Classic Hodgkin Lymphoma"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5103-0694","authenticated-orcid":false,"given":"Mohammad","family":"Ma\u2019koseh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"},{"name":"School of Medicine, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Abufara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Albaghdadi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3942-0173","authenticated-orcid":false,"given":"Ruba","family":"Ghalayni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Abdel-Razeq","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Alzughali","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadwa","family":"Abdel Rahman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-1371","authenticated-orcid":false,"given":"Yazan","family":"Alhalaseh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Halahleh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2833-6051","authenticated-orcid":false,"given":"Hikmat","family":"Abdel-Razeq","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan"},{"name":"School of Medicine, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1182\/blood-2013-04-460121","article-title":"Epidemiology of cancer-associated venous thrombosis","volume":"122","author":"Timp","year":"2013","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4848","DOI":"10.1200\/JCO.2009.22.8197","article-title":"Venous thromboembolism in the hematologic malignancies","volume":"27","author":"Falanga","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5322","DOI":"10.1182\/blood-2010-01-258624","article-title":"Thrombotic complications in adult patients with lymphoma: A meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events","volume":"115","author":"Caruso","year":"2010","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/j.1538-7836.2007.02374.x","article-title":"Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy","volume":"5","author":"Khorana","year":"2007","journal-title":"J. Thromb. Haemost."},{"key":"ref_5","first-page":"107","article-title":"Venous Thromboembolism (VTE) in Hospitalized Cancer Patients: Prophylaxis Failure or Failure to Prophylax","volume":"3","author":"Albadainah","year":"2011","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11239-017-1542-9","article-title":"Venous thromboembolism prophylaxis for ambulatory cancer patients, can we do better?","volume":"44","author":"Mansour","year":"2017","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1182\/blood-2007-10-116327","article-title":"Development and validation of a predictive model for chemotherapy-associated thrombosis","volume":"111","author":"Khorana","year":"2008","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1002\/ajh.24466","article-title":"Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients","volume":"91","author":"Antic","year":"2016","journal-title":"Am. J. Hematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2868","DOI":"10.1002\/cam4.1540","article-title":"Evaluation of the ThroLy score for the prediction of venous thromboembolism in newly diagnosed patients treated for lymphoid malignancies in clinical practice","volume":"7","author":"Gil","year":"2018","journal-title":"Cancer Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.clml.2020.02.021","article-title":"The Incidence of Venous Thromboembolism and Impact on Survival in Hodgkin Lymphoma","volume":"20","author":"Kirkizlar","year":"2020","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12018","DOI":"10.1182\/blood-2022-164529","article-title":"Venous Thromboembolism (VTE) in Patients with Hodgkin Lymphoma: Retrospective Evaluation of Throly and Khorana Risk Scores","volume":"140","author":"Assanto","year":"2022","journal-title":"Blood"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1093\/annonc\/mdz168","article-title":"Thrombosis as a treatment complication in Hodgkin lymphoma patients: A comprehensive analysis of three prospective randomized German Hodgkin Study Group (GHSG) trials","volume":"30","author":"Borchmann","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5377","DOI":"10.1182\/blood-2010-02-270116","article-title":"Prediction of venous thromboembolism in cancer patients","volume":"116","author":"Ay","year":"2010","journal-title":"Blood"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1634\/theoncologist.2016-0414","article-title":"A predictive score for thrombosis associated with breast, colorectal, lung, or ovarian cancer: The prospective COMPASS-cancer-associated thrombosis study","volume":"22","author":"Gerotziafas","year":"2017","journal-title":"Oncologist"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1634\/theoncologist.2015-0361","article-title":"A validated risk score for venous thromboembolism is predictive of cancer progression and mortality","volume":"21","author":"Kuderer","year":"2016","journal-title":"Oncologist"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1111\/jth.13378","article-title":"Predictors of active cancer thromboembolic outcomes: Validation of the Khorana score among patients with lung cancer","volume":"14","author":"Mansfield","year":"2016","journal-title":"J. Thromb. Haemost."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.thromres.2016.12.013","article-title":"The Khorana score for the prediction of venous thromboembolism in patients with pancreatic cancer","volume":"150","author":"Franke","year":"2017","journal-title":"Thromb. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1177\/1076029617699088","article-title":"Performance of Khorana risk score for prediction of venous thromboembolism in patients with hepatocellular carcinoma","volume":"24","author":"Wang","year":"2018","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1177\/1076029617692880","article-title":"The Application of Current Proposed Venous Thromboembolism Risk Assessment Model for Ambulatory Patients with Cancer","volume":"24","author":"Mansour","year":"2018","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.blre.2017.10.002","article-title":"Venous thromboembolic events in lymphoma patients: Actual relationships between epidemiology, mechanisms, clinical profile and treatment","volume":"32","author":"Antic","year":"2017","journal-title":"Blood Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1182\/blood-2020-141367","article-title":"Throly Score Successfully Classifies Hodgkin Lymphoma Patients at Risk of Thromboembolic Complication","volume":"136","author":"Antic","year":"2020","journal-title":"Blood"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1200\/JCO.2013.54.8800","article-title":"Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: The Lugano classification","volume":"32","author":"Cheson","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3746","DOI":"10.1200\/JCO.2007.11.6525","article-title":"Early interim 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin\u2019s lymphoma: A report from a joint Italian-Danish study","volume":"25","author":"Gallamini","year":"2007","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.3324\/haematol.2018.209114","article-title":"The Khorana score for prediction of venous thromboembolism in cancer patients: A systematic review and meta-analysis","volume":"104","author":"Mulder","year":"2019","journal-title":"Haematologica"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Hohaus, S., Bartolomei, F., Cuccaro, A., Maiolo, E., Alma, E., D\u2019al\u00f2, F., Bellesi, S., Rossi, E., and De Stefano, V. (2020). Venous Thromboembolism in Lymphoma: Risk Stratification and Antithrombotic Prophylaxis. Cancers, 12.","DOI":"10.3390\/cancers12051291"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"10760296211045908","DOI":"10.1177\/10760296211045908","article-title":"The Application of the ThroLy Risk Assessment Model to Predict Venous Thromboembolism in Patients with Diffuse Large B-Cell Lymphoma","volume":"27","author":"Mansour","year":"2021","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"S\u00f8rensen, H.T., Pedersen, L., van Es, N., B\u00fcller, H.R., and Horv\u00e1th-Puh\u00f3, E. (2023). Impact of venous thromboembolism on the mortality in patients with cancer: A population-based cohort study. Lancet Reg. Health Eur., 34.","DOI":"10.1016\/j.lanepe.2023.100739"},{"key":"ref_28","first-page":"5","article-title":"Prediction of venous thromboembolism in newly diagnosed patients treated for lymphoid malignancies: Validation of the Khorana Risk Score","volume":"35","author":"Gil","year":"2017","journal-title":"Med. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Calabretta, E., d\u2019Amore, F., and Carlo-Stella, C. (2019). Immune and Inflammatory Cells of the Tumor Microenvironment Represent Novel Therapeutic Targets in Classical Hodgkin Lymphoma. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20215503"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/436\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:45:47Z","timestamp":1760103947000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,12]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13020436"],"URL":"https:\/\/doi.org\/10.3390\/jcm13020436","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,12]]}}}