ThroLy score explained
The Thrombosis Lymphoma (ThroLy) predictive score is a multivariable model for assessing the probability of thromboembolic events in patients with lymphoma. (Multivariable models are those that incorporate multiple independent variables.)
Characteristics
The ThroLy score was developed and published in 2016 by a group of physicians from Serbia and the United States.[1] As a simple model, it was initially internally validated based on individual clinical and laboratory patient characteristics that identify lymphoma patients at risk for a thromboembolic event. Based on an investigation that was conducted on derivation and validation cohorts, it was determined that the variables independently associated with a risk of thromboembolism in lymphoma patients are: previous venous and/or arterial events; mediastinal involvement; a BMI greater than 30 kg/m2; reduced mobility; extra-nodal localization; neutropenia; and a hemoglobin level less than 100g/L. [2]
!Patient characteristics!Assigned score| Previous venous thromboembolic event | 2 |
| Reduced mobility | 1 |
| Previous acute myocardial infarction or stroke | 2 |
| Obesity (BMI ≥ 30) | 2 |
| Extranodal localization | 1 |
| Mediastinal involvement | 2 |
| Neutropenia | 1 |
| Hemoglobin˂100g/L | 1 | |
Risk classification
Based on the risk score, patients with lymphoma can be classified into three different risk groups.
!Risk group!ThroLy score| Low risk | 0-1 |
| Intermediate risk | 2-3 |
| High risk | ≥4 | |
Further validations
The ThroLy score considers some particular characteristics of lymphoma patients, such as extranodal localization and mediastinal involvement. In addition to having a strong positive predictive value, the score is not limited to either hospitalized or outpatient settings, and does not require non-routine laboratory analyses. ThroLy score has been validated by multiple studies and entered clinical practice in several medical centers.[3] [4] [5] However, multiple validation studies are ongoing and the results of additional studies may be needed before it can be fully applicable in clinical practice worldwide; several validation studies have been performed, and several more are ongoing.[6] [7] [8]
Notes and References
- Antic. Darko. Milic. Natasa. Nikolovski. Srdjan. Todorovic. Milena. Bila. Jelena. Djurdjevic. Predrag. Andjelic. Bosko. Djurasinovic. Vladislava. Sretenovic. Aleksandra. Vukovic. Vojin. Jelicic. Jelena. October 2016. Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients: Multivariable Predictive Model. American Journal of Hematology. en. 91. 10. 1014–1019. 10.1002/ajh.24466. 27380861. 1724916. free.
- Abdel-Razeq . Hikmat . Ma’koseh . Mohammad . Mansour . Asem . Bater . Rayan . Amarin . Rula . Abufara . Alaa . Halahleh . Khalid . Manassra . Mohammad . Alrwashdeh . Mohammad . Almomani . Mohammad . Zmaily . Mais . January 2021 . The Application of the ThroLy Risk Assessment Model to Predict Venous Thromboembolism in Patients with Diffuse Large B-Cell Lymphoma . Clinical and Applied Thrombosis/Hemostasis . en . 27 . 107602962110459 . 10.1177/10760296211045908 . 1076-0296 . 8642105 . 34590497.
- Ma’koseh . Mohammad . Abufara . Alaa . Albaghdadi . Dana . Ghalayni . Ruba . Abdel-Razeq . Sarah . Alzughali . Eman . Abdel Rahman . Fadwa . Alhalaseh . Yazan . Halahleh . Khalid . Abdel-Razeq . Hikmat . 2024-01-12 . The Application of Existing Risk Assessment Models (RAMS) to Predict the Occurrence of Venous Thromboembolic Events among Patients with Classic Hodgkin Lymphoma . Journal of Clinical Medicine . en . 13 . 2 . 436 . 10.3390/jcm13020436 . free . 2077-0383 . 10816014 . 38256570.
- Sánchez Prieto . Irene . Gutiérrez Jomarrón . Isabel . Martínez Vázquez . Celia . Rodríguez Barquero . Pedro . Gili Herreros . Paula . García-Suárez . Julio . 2024-04-27 . Comprehensive evaluation of genetic and acquired thrombophilia markers for an individualized prediction of clinical thrombosis in patients with lymphoma and multiple myeloma . Journal of Thrombosis and Thrombolysis . en . 10.1007/s11239-024-02977-0 . 1573-742X. free . 11315779 .
- Leviatan . Ilona . Ellis . Martin H. . December 2023 . Use of direct oral anticoagulants in hematologic malignancies . Thrombosis Update . en . 13 . 100152 . 10.1016/j.tru.2023.100152. free .
- Rupa-Matysek. Joanna. Brzeźniakiewicz-Janus. Katarzyna. Gil. Lidia. Krasiński. Zbigniew. Komarnicki. Mieczysław. July 2018. Evaluation of the ThroLy score for the prediction of venous thromboembolism in newly diagnosed patients treated for lymphoid malignancies in clinical practice. Cancer Medicine. en. 7. 7. 2868–2875. 10.1002/cam4.1540. 6051175. 29761831.
- Antic . Darko . Milic . Natasa . Mihaljevic . Biljana . Cheson . Bruce . Narkhede . Mayur . Abdel-Razeq . Hikmat . Panovska . Irina . Trajkova . Sanja . Popova . Marija . Aurer . Igor . Boban . Ana . November 29, 2018 . External Validation and Revision of Thrombosis Lymphoma /Throly/ Score . Blood . en . 132 . Supplement 1 . 140 . 10.1182/blood-2018-99-115568 . 0006-4971 . free.
- Assanto . Giovanni Manfredi . Salvatori . Martina . Pontecorvo . Sara . Maiorana . Gianluca . Cenfra . Natalia . D’elia . Gianna Maria . Bianchi . Maria Paola . Annechini . Giorgia . Santoro . Cristina Santoro . Martelli . Maurizio . Tafuri . Agostino . Pulsoni . Alessandro . Del Giudice . Ilaria . Chistolini . Antonio . August 2023 . S219: Predicting Thrombotic Risk in Patients with Hodgkin Lymphoma: A Multicentric Study of Throly and Khorana Risk Scores . HemaSphere . en-US . 7 . S3 . e700140a . 10.1097/01.HS9.0000967788.70014.0a . 2572-9241. 10428474 .
