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Thromboprophylaxis in Cancer Patients

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Abstract

The course of cancer is frequently complicated by the occurrence of thromboembolic disease. Typical presentations include venous thromboembolism (VTE), including deep vein thrombosis (DVT), pulmonary embolism (PE) and splanchnic vein thromboses, as well as arterial thromboembolism including stroke and myocardial infarction.

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References

  1. Prandoni P, Lensing AW, Piccioli A, et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood. 2002;100:3484-3488.

    Google Scholar 

  2. Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007;5:632-634.

    Google Scholar 

  3. Khorana AA, Dalal MR, Lin J, Connolly GC. Health care costs associated with venous thromboembolism in selected high-risk ambulatory patients with solid tumors undergoing chemotherapy in the United States. Clinicoecon Outcomes Res. 2013;5:101-108.

    Google Scholar 

  4. Moore RA, Adel N, Riedel E, et al. High incidence of thromboembolic events in patients treated with cisplatin-based chemotherapy: a large retrospective analysis. J Clin Oncol. 2011;29:3466-3473.

    Google Scholar 

  5. Khorana AA, Dalal M, Tangirala K, et al. Higher incidence of venous thromboembolism in the outpatient versus the inpatient setting among U.S. cancer patients. Blood (ASH Annual Meeting Abstracts). 2011;118:Abstract 674.

    Google Scholar 

  6. Khorana AA, Connolly GC. Assessing risk of venous thromboembolism in the patient with cancer. J Clin Oncol. 2009;27:4839-4847.

    Google Scholar 

  7. Blom JW, Doggen CJ, Osanto S, et al. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA. 2005;293:715-722.

    Google Scholar 

  8. Dickmann B, Ahlbrecht J, Ay C, et al. Regional lymph node metastases are a strong risk factor for venous thromboembolism: results from the Vienna Cancer and Thrombosis Study. Haematologica. 2013;98:1309-1314.

    Google Scholar 

  9. Scappaticci FA, Fehrenbacher L, Cartwright T, et al. Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol. 2005;91:173-180.

    Google Scholar 

  10. Choueiri TK, Schutz FA, Je Y, et al. Risk of arterial thromboembolic events with sunitinib and sorafenib: a systemic review and meta-analysis of clinical trials. J Clin Oncol. 2010;28:2280-2285.

    Google Scholar 

  11. Cavo M, Zamagni E, Cellini C, et al. Deep-vein thrombosis in patients with multiple myeloma receiving first-line thalidomide-dexamethasone therapy. Blood. 2002;100:2272-2273.

    Google Scholar 

  12. Petrelli F, Cabiddu M, Borgonovo K, Barni S. Risk of venous and arterial thromboembolic events associated with anti-EGFR agents: a meta-analysis of randomized clinical trials. Ann Oncol. 2012;23:1672-1679.

    Google Scholar 

  13. Gomes M, Khorana AA. Risk assessment for thrombosis in cancer. Semin Thromb Hemost. 2014;40:319-324.

    Google Scholar 

  14. Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111:4902-4907.

    Google Scholar 

  15. Stender MT, Frokjaer JB, Larsen TB, Lundbye-Christensen S, Thorlacius-Ussing O. Preoperative plasma D-dimer is a predictor of postoperative deep venous thrombosis in colorectal cancer patients: a clinical, prospective cohort study with one-year followu-up. Dis Colon Rectum. 2009;52:446-451.

    Google Scholar 

  16. Ay C, Vormittag R, Dunkler D, et al. D-dimer and prothrombin fragment 1 + 2 predict venous thromboembolism in patients with cancer: results from the Vienna Cancer and Thrombosis Study. J Clin Oncol. 2009;27:4124-4129.

    Google Scholar 

  17. Ay C, Dunkler D, Simanek R, et al. Prediction of venous thromboembolism in patients with cancer by measuring thrombin generation: results from the Vienna Cancer and Thrombosis Study. J Clin Oncol. 2011;29:2099-2103.

    Google Scholar 

  18. Khorana AA, Ahrendt SA, Ryan CK, et al. Tissue factor expression, angiogenesis, and thrombosis in pancreatic cancer. Clin Cancer Res. 2007;13:2870-2875.

    Google Scholar 

  19. Khorana AA, Francis CW, Menzies KE, et al. Plasma tissue factor may be predictive of venous thromboembolism in pancreatic cancer. J Thromb Haemost. 2008;6:1983-1985.

    Google Scholar 

  20. Zwicker JI, Liebman HA, Neuberg D, et al. Tumor-derived tissue factor-bearing microparticles are associated with venous thromboembolic events in malignancy. Clin Cancer Res. 2009;15:6830-6840.

    Google Scholar 

  21. Ay C, Simanek R, Vormittag R, et al. High plasma levels of soluble P-selectin are predictive of venous thromboembolism in cancer patients: results from the Vienna Cancer and Thrombosis Study (CATS). Blood. 2008;112:2703-2708.

    Google Scholar 

  22. Vormittag R, Simanek R, Ay C, et al. High factor VIII levels independently predict venous thromboembolism in cancer patients: the cancer and thrombosis study. Arterioscler Thromb Vasc Biol. 2009;29:2176-2181.

    Google Scholar 

  23. Lyman GH, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:2189-2204.

    Google Scholar 

  24. Ay C, Dunkler D, Marosi C, et al. Prediction of venous thromboembolism in cancer patients. Blood. 2010;116:5377-5382.

    Google Scholar 

  25. Mandala M, Clerici M, Corradino I, et al. Incidence, risk factors and clinical implications of venous thromboembolism in cancer patients treated within the context of phase I studies: the ‘SENDO experience’. Ann Oncol. 2012;23:1416-1421.

    Google Scholar 

  26. Palumbo A, Rajkumar SV, Domopoulos MA, et al. Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. Leukemia. 2008;22:414-423.

    Google Scholar 

  27. National Comprehensive Cancer Network. Cancer-associated Venous Thromboembolic Disease. www.nccn.org/professionals/physician_gls/pdf/vte.pdf. Accessed January 19, 2016.

  28. Mandala M, Falanga A, Roila F. Management of venous thromboembolism (VTE) in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2011;22:vi85-vi92.

    Google Scholar 

  29. Khorana AA. Venous thromboembolism prevetion in cancer outpatients. J Natl Compr Canc Netw. 2013;11:1431-1438.

    Google Scholar 

  30. 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;10:943-949.

    Google Scholar 

  31. Agnelli G, George DJ, Kakkar AK, et al. Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer. N Engl J Med. 2012;366:601-609.

    Google Scholar 

  32. Maraveyas A, Waters J, Roy R, et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. Eur J Cancer. 2012;48:1283-1292.

    Google Scholar 

  33. Riess H, Pelzer U, Opitz B, 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;27(suppl; abstr LBA4506).

    Google Scholar 

  34. Larocca A, Cavallo F, Bringhen S, et al. Aspirin or enoxaparin thromboprophylaxis for patients with newly diagnosed multiple myeloma treated with lenalidomide. Blood. 2012;119:933-939.

    Google Scholar 

  35. Palumbo A, Cavo M, Bringhen S, et al. Aspirin, warfarin, or enoxaparin thromboprophylaxis in patients with multiple myeloma treated with thalidomide: a phase III, open-label, randomized trial. J Clin Oncol. 2011;29:986-993.

    Google Scholar 

  36. Perry JR, Julian JA, Laperriere NJ, et al. PRODIGE: a randomized placebo-controlled trial of dalteparin low-molecular-weight heparin thromboprophylaxis in patients with newly diagnosed malignant glioma. J Thromb Haemost. 2010;8:1959-1965.

    Google Scholar 

  37. Verso M, Agnelli G, Barni S, Gasparini G, LaBianca R. A modified Khorana risk assessment score for venous thromboembolism in cancer patients receiving chemotherapy: the Protecht score. Intern Emerg Med. 2012;7:291-292.

    Google Scholar 

  38. George DJ, Agnelli G, Fisher W, et al. Venous thromboembolism (VTE) prevention with semuloparin in cancer patients initiating chemotherapy: benefit-risk assessment by VTE risk in SAVE-ONCO. Blood (ASH Annual Meeting Abstracts). 2011;118:Abstract 206.

    Google Scholar 

  39. Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141:e195S-e226S.

    Google Scholar 

  40. Cohen AT, Davidson BL, Gallus AS, et al. Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ. 2006;332:325-329.

    Google Scholar 

  41. Leizorovicz A, Cohen AT, Turpie AGG, et al. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation. 2004;110:874-879.

    Google Scholar 

  42. Carrier M, Khorana AA, Moretto P, et al. Lack of evidence to support thromboprophylaxis in hospitalized medical patients with cancer. Am J Med. 2014;127:82-86.

    Google Scholar 

  43. Zwicker JI, Rojan A, Campigotto F, et al. A pattern of frequent but non-targeted pharmacologic thromboprophylaxis of hospitalized cancer patients at academic medical centers: a prospective, cross-sectional, multi-center study. J Clin Oncol. 2014;32;1792-1796.

    Google Scholar 

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Eads, J.R., Khorana, A.A. (2016). Thromboprophylaxis in Cancer Patients. In: Perry, D., Warwick, D. (eds) Handbook of Thromboprophylaxis. Adis, Cham. https://doi.org/10.1007/978-3-319-21148-0_10

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  • DOI: https://doi.org/10.1007/978-3-319-21148-0_10

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  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-21147-3

  • Online ISBN: 978-3-319-21148-0

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