venous thromboembolism associated with malignancy
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Etiology
- carcinomas, esp. adenocarcinoma (1,2,3)
- advanced stage cancers, myeloproliferative disorders or myelodysplastic syndrome at highest risk[4]
Management
- use LMW heparin rather than warfarin in patients with underlying malignancy based mostly on single trial[5]
- LMW heparin & warfarin equivalent[5]
- oral anticoagulant edoxaban noninferior to subcutaneous dalteparin for managing venous thromboembolism (VTE) in adults with cancer[6]
- direct oral anticoagulants associated with less recurrent VTE but more major bleeding compared with LMW heparins.
More general terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015
- ↑ Merli G et al Subcutaneous enoxaparin once or twice daily compared with intravenous unfractionated heparin for treatment of venous thromboembolic disease. Ann Intern Med 134:191, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11177331
- ↑ Trujillo-Santos J et al, Clinical outcome in patients with venous thromboembolism and hidden cancer. Findings from the RIETE Registry. J Thromb Haemost 2008, 6:251 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18021305
- ↑ 4.0 4.1 Chee CE et al. Predictors of venous thromboembolism recurrence and bleeding among active cancer patients: A population-based cohort study. Blood 2014 Apr 2 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24782507 <Internet> http://bloodjournal.hematologylibrary.org/content/early/2014/04/29/blood-2014-01-549733
- ↑ 5.0 5.1 5.2 Lee AYY et al. Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: A randomized clinical trial. JAMA 2015 Aug 18; 314:677. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26284719
- ↑ 6.0 6.1 Raskob GE, van Es N, Verhamme P et al Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism. N Engl J Med. Dec 12, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29231094 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1711948
- ↑ Mulder FI et al. Direct oral anticoagulants for cancer-associated venous thromboembolism: A systematic review and meta-analysis. Blood 2020 Sep 17; 136:1433 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32396939 https://ashpublications.org/blood/article-abstract/136/12/1433/455308/Direct-oral-anticoagulants-for-cancer-associated?redirectedFrom=fulltext