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Khorana Risk Score for Venous Thromboembolism in Cancer Patients

Predicts chemotherapy-associated VTE risk from tumour site and pre-chemotherapy labs.

Khorana Risk Score for Venous Thromboembolism in Cancer Patients
Primary tumour site
Pre-chemotherapy platelet count >=350 x 10^9/L
Hemoglobin <10 g/dL, or use of erythropoiesis-stimulating agents
Pre-chemotherapy leukocyte count >11 x 10^9/L
BMI >=35 kg/m^2
Result0 points

Low-risk for chemotherapy-associated venous thromboembolism.

VTE risk group
Low

When to use

  • Estimating VTE risk before starting chemotherapy to inform discussion or use of pharmacologic thromboprophylaxis in ambulatory cancer patients.

Formula

Points: cancer site (stomach/pancreas = 2; lung, lymphoma, gynaecologic, bladder, testicular = 1; other = 0); platelets >=350x10^9/L = 1; hemoglobin <10 g/dL or ESA use = 1; leukocytes >11x10^9/L = 1; BMI >=35 = 1. Low 0, Intermediate 1-2, High >=3.

Pearls and pitfalls

  • Derived and validated in ambulatory patients about to start systemic chemotherapy, not hospitalised patients.

References

  1. Khorana AA, Kuderer NM, Culakova E, et al. Blood. 2008;111(10):4902-7.