Abstract 296P
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 patients. This systematic review and meta-analysis aims to quantify the association of IDH mutation status with risks of VTE in glioma patients.
Methods
We searched PubMed, Google Scholar, Medline OVID, Cochrane library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to identify relevant studies that investigated the association between IDH mutation and VTE in glioma. The overall odd ratio (OR) was pooled using the random-effects model to take into account the expected heterogeneity among included studies. The statistical heterogeneity of the pooled effects was estimated using Cochran's Q statistics and I2 tests. We performed subgroup analyses according to age, tumor grade (low-grade vs high-grade), study design, and study quality.
Results
A total of 2600 patients from 8 studies were included in the meta-analysis. All included studies were published between 2016 and 2021. The pooled OR of VTE in glioma patients with IDH mutation was 0.21 (95% confidence interval [CI]: 0.09-0.46, I2=34%) in mutant-type IDH gliomas when compared to those with wild-type IDH. The association of IDH mutation with VTE varies with tumor grade. Among high-grade (III and IV) glioma patients, 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). There was only moderate statistical heterogeneity in the overall result. Meta-regression analysis showed no evidence of a linear relationship with age, retrospective versus prospective, or the quality of study.
Conclusions
IDH mutation is significantly associated with a 70% decrease in VTE risk among high-grade glioma patients. Our findings suggest the potential clinical utility of IDH mutation status regarding thromboprophylaxis, and the need for further studies to elucidate the observed association.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.