Men with advanced germ cell tumors (GCT) treated with chemotherapy are at high risk of venous thromboembolism (VTE). Predictors of VTE may identify patients who would benefit from prophylactic anticoagulation. Men with advanced GCT (Stage IS, II, III) treated with chemotherapy were identified at 2 centers. High genomic risk was defined from a 5 single nucleotide polymorphism (SNP) germline panel. Logistic regression was used to evaluate the impact of genomic risk on VTE within 6 months of chemotherapy initiation. Orthogonal Projection to Latent Structures Discriminant Analysis (OPLS-DA) was used to build models to predict VTE based on clinical variables and an 86 SNP panel. This 123-patient cohort experienced a VTE rate of 26% with an incidence of high genomic risk of 21%. Men with high genomic risk did not have a significantly higher VTE rate (31%, 8/26) than men with low genomic risk (25%, 24/97), unadjusted OR 1.4 (95% CI 0.5-3.5, = .54). Incorporation of clinical variables (Khorana score, N3 status and elevated LDH) resulted in adjusted OR 2.1 (95% CI 0.7-6.5, = .18). A combined model using clinical variables and 86 SNPs performed similarly (AUC 0.77) compared to clinical variables alone (AUC 0.72). A previously established 5-SNP panel was not associated with VTE among patients with GCT receiving chemotherapy. However, multivariable models based on clinical variables alone warrant further validation to inform prophylactic anticoagulation strategies.

中文翻译：

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接受化疗的晚期生殖细胞肿瘤患者的血栓形成率和遗传性血栓形成倾向风险

接受化疗治疗的晚期生殖细胞肿瘤 (GCT) 男性发生静脉血栓栓塞 (VTE) 的风险很高。 VTE 的预测因素可以确定哪些患者可以从预防性抗凝治疗中受益。在 2 个中心发现接受化疗的晚期 GCT（IS、II、III 期）男性。高基因组风险是通过 5 个单核苷酸多态性 (SNP) 种系组来定义的。使用逻辑回归来评估化疗开始后 6 个月内基因组风险对 VTE 的影响。使用正交投影潜在结构判别分析 (OPLS-DA) 构建模型，根据临床变量和 86 个 SNP 组预测 VTE。这个由 123 名患者组成的队列的 VTE 率为 26%，高基因组风险发生率为 21%。基因组风险高的男性 VTE 率 (31%, 8/26) 并不比基因组风险低的男性 (25%, 24/97) 显着更高，未经调整 OR 1.4 (95% CI 0.5-3.5, = 0.54) ）。合并临床变量（Khorana 评分、N3 状态和 LDH 升高）导致调整后的 OR 2.1 (95% CI 0.7-6.5, = .18)。使用临床变量和 86 个 SNP 的组合模型与单独的临床变量 (AUC 0.72) 相比，表现相似 (AUC 0.77)。先前建立的 5-SNP 组合与接受化疗的 GCT 患者中的 VTE 无关。然而，仅基于临床变量的多变量模型需要进一步验证，以告知预防性抗凝策略。