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Current Recommendations for the Prevention and Treatment of Venous Thromboembolism in Cancer Patients


Authors: J. Halámková 1,2;  M. Penka 3
Authors‘ workplace: Klinika komplexní onkologické péče LF MU a Masarykův onkologický ústav, Brno 1;  Ústav lékařské etiky, LF MU, Brno 2;  Oddělení klinické hematologie, LF MU a FN Brno 3
Published in: Klin Onkol 2017; 30(2): 100-105
Category: Reviews
doi: https://doi.org/doi: 10.14735/amko2017100

Overview

About 20% of patients suffer from venous thromboembolism (VTE) during oncology disease. Active cancer, along with cancer therapy, increases the risk of VTE, especially in the first 6 months after diagnosis. Most often VTE accompanies haematological malignancies and CNS tumours, and gastrointestinal, breast, lung, ovary and uterine cancer. The presence of distant metastases, together with the implantation of a central venous catheter, increases the risk even more. A cancer patient also has a 2–5× higher risk of recurrence of VTE during anticoagulant therapy than patients without a malignancy, as well as a 2–6× higher risk of serious bleeding. Thromboembolic disease is also an independent prognostic factor for death in patients with malignant tumours. Management of VTE is a part of everyday oncological practice, and oncologists should be aware of the basic recommendations regarding individual medical procedures and the clinical situations that may occur in cancer patients. They should also be able to adequately treat VTE when it occurs. It is necessary to consider some specificity during prophylaxis, diagnostics and treatment of venous thromboembolism in cancer care. The International Initiative on Thrombosis and Cancer (ITAC-CME) has created a mobile application based on international guidelines for the prevention and treatment of venous thromboembolism. It is a simple schematic algorithm for making decisions, and it helps in choosing the best therapeutic strategy and supports the judicious and appropriate use of anticoagulants for prophylaxis and treatment of VTE in cancer patients. This text contains a summary of the recommendations applicable in routine clinical practice.

Key words:
venous thromboembolism – cancer – central venous catheter thrombosis – guidelines

This work was supported by Czech Ministry of Health – RVO (MMCI, 00209805).

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
1. 8. 2016

Accepted:
26. 10. 2016


Sources

1. Hirmerová J, Karetová D, Malý R et al. Akutní žilní trombóza 2014: současný stav prevence, diagnostiky a léčby. Doporučený postup české angiologická společnosti ČLS JEP [citováno 23. července 2016]. Dostupné z: http: //csth.cz/index.php?goto=doporucene postupy.

2. Farge D, Debourdeau P, Beckers M et al. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. J Thromb Haemost 2013; 11 (1): 56–70. doi: 10.1111/jth.12070.

3. Chew HK, Wun T, Harvey D et al. Incidence of venous trombembolism and its effect on survival among patients with common cancers. Arch Intern Med 2006; 166 (4): 458–464.

4. Lyman GH, Bohlke K, Khorana AA et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: american society of clinical oncology clinical practice guideline update 2014. J Clin Oncol 2015; 33 (6): 654–656. doi: 10.1200/JCO.2014.59.7351.

5. Agnelli G, Gussoni G, Bianchini C et al. Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study. Lancet Oncol 2009; 10 (10): 943–949. doi: 10.1016/S1470-2045 (09) 70232-3.

6. Verso M, Gussoni G, Agnelli G. Prevention of venous thromboembolism in patients with advanced lung cancer receiving chemotherapy: a combined analysis of the PROTECHT and TOPIC-2 studies. J Thromb Haemost 2010; 8 (7): 1649–1651. doi: 10.1111/j.1538-7836.2010.03901.x.

7. Maraveyas A, Waters J, Roy R et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. Eur J Cancer 2012; 48 (9): 1283–1292. doi: 10.1016/j.ejca.2011.10.017.

8. Riess H, Pelzer U, Opitz et al. A prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy: final results of the CONKO-004 trial. J Clin Oncol 2010; 28 (Suppl 15): abstr. 4033.

9. Becattini C, Agnelli G, Schenone A et al. Aspirin for preventing the recurrence of venous thromboembolism. N Engl J Med 2012; 366 (21): 1959–1967. doi: 10.1056/ NEJMoa1114238.

10. Debourdeau P, Farge D, Beckers M et al. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost 2013; 11 (1): 71–80. doi: 10.1111/jth.12 071.

11. Short NJ, Connors JM. New oral anticoagulants and the cancer patient. Oncologist 2014; 19 (1): 82–93. doi: 10.1634/theoncologist.2013-0239.

12. Levitan N, Dowlati A, Remick SC et al. Rates of initial and recurrent thromboembolic disease among patients with malignancy versus those without malignancy. Risk analysis using Medicare claims data. Medicine (Baltimore) 1999; 78 (5): 285–291.

13. Ay C, Dunkler D, Marosi C et al. Prediction of venous thromboembolism in cancer patients. Blood 2010; 116 (24): 5377–5382. doi: 10.1182/blood-2010-02-270 116.

14. Farge-Bancel D, Bounameaux H, Brenner B et al. Implementing thrombosis guidelines in cancer patients: a review. Rambam Maimonides Med J 2014; 5 (4): e0041. doi: 10.5041/RMMJ.10175.

15. Khorana AA, Kuderer NM, Culakova E et al. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 2008; 111 (10): 4902–4907. doi: 10.1182/blood-2007-10-116327.

16. Lyman GH, Khorana AA, Falanga A et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25 (34): 5490–5505.

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