需要关于直接口服抗凝剂（DOACs）用于血液肿瘤（HM）引起的静脉血栓栓塞（VTE）的数据。迄今为止的回顾性研究缺乏对照组，且未集中研究VTE患者。我们的目的是评估HM患者使用低分子肝素（LMWH）或DOACs治疗急性VTE时的VTE再发率和出血情况。这是一项回顾性队列研究，包括HM和新诊断的VTE患者，在抗凝治疗的第一天索引，并进行12个月的后续随访。结果为再发VTE、大出血或临床相关的非重大出血组成的复合结局。对于每种抗凝组（LMWH、DOAC），计算了累积发生率[95%置信区间（CI）]，并使用cox比例风险模型计算了风险比（HR），以死亡作为竞争风险。共纳入了143例接受LMWH（96）或DOACs（47）治疗急性VTE的HM患者。最常见的HM类型为淋巴瘤（83例，58%）和浆细胞增生症（32例，22.3%）。LMWH组合成复合结局的12个月累计发生率为24.2%（95% CI 15.9-33.5%；n = 22），DOAC组为18.5%（8.5-31.5%；n = 8）（HR 1.51 [0.695-3.297]）。两例再发VTE发生在DOAC组（停药期间）。 9例（9.4%）接受LMWH治疗的患者出现了重大出血，与1例（2.1%）接受DOAC治疗的患者相比（HR 4.85 [0.64-36.56]）。该研究提出了DOACs可能是治疗本研究所涵盖的HM患者VTE时LMWH的安全有效替代品的假设。©2023.作者（们）授权Springer Science+Business Media，LLC的独家使用权，Springer Nature的一部分。

Data are needed on direct oral anticoagulants (DOACs) for the treatment of venous thromboembolism (VTE) in hematological malignancies (HM). Retrospective studies to date lacked a control group and did not focus on patients with VTE. Out aim was to assess the incidence of VTE recurrence and bleeding in HM patients treated with low molecular weight heparin (LMWH) or DOACs for acute VTE. This is a retrospective cohort study including patients with active HM and newly-diagnosed VTE, indexed on the first day of anticoagulation and followed for 12 months. The outcome was a composite of recurrent VTE, major bleeding or clinically relevant non-major bleeding. Cumulative incidence [95% confidence interval (CI)] was calculated for each anticoagulation group (LMWH, DOAC) and hazard ratios (HR) were calculated using cox-proportional hazards model, with death as a competing risk. 143 HM patients treated with LMWH (96) or DOACs (47) for acute VTE were included. The most common HM types were lymphoma in 83 (58%) and plasma cell dyscrasia in 32 (22.3%). The 12-month cumulative incidence of the composite outcome was 24.2% (95% CI 15.9-33.5%; n = 22) in the LMWH group and 18.5% (8.5-31.5%; n = 8) in the DOAC group (HR 1.51 [0.695-3.297]). Two recurrent VTE occurred (both in the DOAC group while off-treatment). Nine (9.4%) LMWH-treated patients had major bleeding compared to 1 (2.1%) DOAC-treated patient (HR 4.85 [0.64-36.56]). This study generates the hypothesis that DOACs may be a safe and effective alternative to LMWH for VTE in patients with HM types represented in the study.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.