Risk of venous thromboembolism and primary prophylaxis in cancer

I. Pabinger; C. Ay

doi:10.5482/ha-1173

Hämostaseologie, Table of Contents

Hamostaseologie 2012; 32(02): 132-137
DOI: 10.5482/ha-1173

Review

Schattauer GmbH

Risk of venous thromboembolism and primary prophylaxis in cancer

Should all patients receive thromboprophylaxis?Risiko für venöse Thromboembolien und Primärprophylaxe bei KrebsSollten alle Patienten eine Thromboseprophylaxe erhalten?

I. Pabinger

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

,

C. Ay

¹Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria

› Author Affiliations

Abstract

Summary

Venous thromboembolism (VTE) is a common complication in patients with cancer that causes significant morbidity and mortality. Several patient-, tumour-and treatment-related risk factors for VTE in cancer patients have been identified. An effective and safe thromboprophylaxis in cancer patients at high risk of VTE is desirable. Recently, the identification of potential biomarkers and the development of risk scoring models for prediction of cancer-associated VTE have been published. Whether primary VTE prophylaxis based on risk assessment through these biomarkers and risk prediction models might be useful, is currently not yet known. However, thromboprophylaxis is clearly indicated in high-risk situations. While VTE prophylaxis is recommended in cancer patients undergoing surgery and in hospitalised patients with acute disease, studies in ambulatory cancer patients are still rare and evidence for primary VTE prophylaxis is currently limited. In this review, risk factors associated with VTE in cancer patients and current approaches of thromboprophylaxis in different settings, specifically in ambulatory cancer patients are subjected to a critical evaluation.

Zusammenfassung

Die venöse Thromboembolie (VTE) ist eine häufige Komplikation bei Krebspatienten mit erheblicher Morbidität und Mortalität. Verschiedene patienten-, tumor-und behandlungsbezogene Risikofaktoren für VTE bei Krebspatienten sind bekannt. Eine wirksame und sichere Thromboseprophylaxe für Krebspatienten mit einem hohen VTE-Risiko ist wünschenswert. Die Identifizierung potenzieller Biomarker und die Entwicklung eines Risikovorhersage-Modells für krebsassoziierte VTE wurden kürzlich publiziert. In wie weit eine primäre VTE-Prophylaxe auf Grundlage der Risikobeurteilung mit Hilfe dieser Biomarker und Risikovorhersage-Modelle vorteilhaft sein kann, ist zurzeit nicht bekannt. In Hochrisikosituationen jedoch ist die Thromboseprophylaxe klar indiziert. Während bei chirurgisch behandelten Krebspatienten und bei stationären Patienten mit akuten Krankheiten eine VTE-Prophylaxe empfohlen wird, liegen kaum Studien mit ambulanten Krebspatienten vor und die Datenlage für eine primäre VTE-Prophylaxe ist momentan beschränkt.

In dieser Übersicht werden Risikofaktoren für VTE bei Krebspatienten und aktuelle Ansätze zur Thromboseprophylaxe, besonders bei ambulanten Krebspatienten, einer kritischen Beurteilung unterzogen.

Keywords

Cancer - venous thromboembolism - thromboprophylaxis

Schlüsselwörter

Krebs - venöse Thromboembolie - Thromboseprophylaxe

Full Text

References

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