Tumor – Chemotherapie – Thrombose

Zusammenfassung

Thromboembolien sind keine seltene Komplikation bei der Behandlung von Tumoren. Zahlreiche Mechanismen verknüpfen Tumorwachstum und Gerinnungsaktivierung. Dazu kommen die thrombosefördernde Wirkung bestimmter Tumorwirkstoffe, das zunehmende Alter der Patienten und deren längeres Überleben. Allen stationären Tumorpatienten sollte eine Thromboseprophylaxe angeboten werden. Bei ambulanten Patienten, die eine tumorspezifische Therapie erhalten, ist der Nutzen einer Thromboseprophylaxe bisher nicht sicher belegt. Bei ambulanten Myelom-Patienten, die IMiDe (Immune Modulatory Drugs; Thalidomid, Revlimid) erhalten und bei Pankreaskarzinom-Patienten mit Chemotherapie wird jedoch eine Thromboseprophylaxe empfohlen. Wenn eine Thromboembolie eingetreten ist gibt man bei Tumorpatienten ein niedermolekulares Heparin in therapeutischer Dosis (Näheres siehe Fachinformation) und solange die Tumorerkrankung aktiv ist, z.T. bis an das Lebensende des Patienten.

Summary

Venous thromboembolism is not an uncommon complication of cancer therapy. Numerous mechanisms link tumor growth with the activation of clotting factors. Increasing age of patients, longer survival, and prothrombogenic effects of anti-cancer drugs add to this risk. All oncology inpatients should be offered thromboprophylaxis. In outpatients the benefit of thromboprophylaxis is still under discussion. Ambulatory myeloma patients with IMiD-therapy (thalidomide, revlimide) and patients with pancreatic carcinoma should be offered prophylactic heparin. The standard treatment of established venous thromboembolism in cancer patients is therapeutic-dose low molecular weight heparin (see specific product informations) as long as the cancer is active, sometimes until the end of life.

Schlüsselwörter

Tumor - Chemotherapie - Thromboembolie

Key words

cancer - chemical therapy - thromboembolism

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