Isocitrate dehydrogenase mutation and risk of venous thromboembolism in glioma: A systematic review and meta-analysis. Issue 219 (November 2022)

• Record Type: Journal Article
• Authors: Low, Soon Khai; Anjum, Zauraiz; Mahmoud, Amir; Joshi, Utsav; Kouides, Peter
• Is Part Of: Thrombosis research. Issue 219(2022)
• Page Start: 14
• Page End: 21
• Publication Date: 2022-11
• Subjects: IDH -- VTE -- Glioma -- Mutation -- meta-analysis; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2022.08.029
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Background: Patients with malignancies including malignant gliomas have a relatively high risk for venous thromboembolism (VTE). Recent evidence has linked isocitrate dehydrogenase (IDH) mutation with reduced VTE risk in malignant glioma. This meta-analysis aims to quantify the association of IDH mutation status with risks of VTE in patients with glioma. Methods: We searched PubMed, Google Scholar, Medline OVID, Cochrane library, Cumulative Index to Nursing and Allied Health Literature databases to identify relevant studies. The overall odd ratio (OR) was pooled using the random-effects model. We evaluated the statistical heterogeneity using Cochran's Q statistics and I 2 tests. We performed subgroup analyses according to age, tumor, study design, and study quality. Results: A total of 2600 patients from 8 studies were included in the meta-analysis. Patients with IDH mutant-type gliomas had a significantly lower risk of VTE (OR: 0.21, 95 % confidence interval [CI]: 0.09–0.46, I2 = 34 %) compared to patients with IDH wild-type gliomas. Among high-grade (III and IV) glioma, VTE events in IDH-mutant gliomas occurred with an OR of 0.28 (95 % CI: 0.14–0.53). No statistically significant decrease in the VTE risk was observed in grade II gliomas with IDH mutation compared to IDH wild-type gliomas, as indicated by the OR of 0.60 (95 % CI: 0.17–2.11). Conclusion: IDH mutation is significantly associated with 79 % lower risk of VTE among patients with high-grade glioma compared to IDH wild-type. Our findings suggest the potential utility of IDH mutation status regarding thromboprophylaxis, and the need for further studies to elucidate the mechanism of the association. Graphical abstract: Unlabelled Image Highlights: IDH mutation is associated with 5-fold lower risk of VTE in high-grade gliomas. Consideration of IDH mutation status in VTE risk prediction among glioma patients Potential utility of IDH mutation status regarding thromboprophylaxis