Blood Biomarkers and VTE Risk in Cancer Patients Receiving ICIs

Corresponding author: Xiaxiaotong, xia.xiaotong@zsxmhospital.com

DOI: 10.12201/bmr.202601.00053

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  Abstract: Objective: To evaluate the predictive value of platelet count (PLT) and aspartate aminotransferase (AST) for venous thromboembolism (VTE) in cancer patients treated with immune checkpoint inhibitors (ICIs). Methods: This retrospective study included 966 cancer patients treated with ICIs from January 2022 to June 2024 at Zhongshan Hospital Xiamen , Fudan University. Clinical and laboratory data were collected. Logistic regression was used to identify VTE-related factors. Restricted cubic spline (RCS) and threshold analysis were performed to assess the dose-response relationships between PLT, AST, and VTE risk. Results: A total of 94 patients (9.73%) developed VTE. Elevated AST (P = 0.008) and reduced PLT (P = 0.020) were independent risk factors for VTE. RCS analysis showed nonlinear relationships: AST-related risk increased above 109 U/L, and PLT-related risk increased below 255×10?/L. Patients with a Khorana score of 1 had significantly lower VTE risk compared to those with a score of 0 (P = 0.011). Conclusion: Elevated AST and decreased PLT are independent predictors of VTE in cancer patients receiving ICIs. Their nonlinear associations and identifiable clinical thresholds highlight their potential utility in individualized thrombosis risk assessment, especially when combined with existing scoring models.

  Key words: Venous thromboembolism (VTE); Immune checkpoint inhibitors (ICIs); Aspartate aminotransferase (AST); Platelet count (PLT) Risk assessment; 

  Submit time: 17 January 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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