Approach to Cancer-Associated Thrombosis: Challenging Situations and Knowledge Gaps

The oncologist

article

Tzu-Fei Wang¹  Henny H. Billett²  Jean M. Connors³  Gerald A. Soff⁴ 

[1] Department of Medicine, University of Ottawa at The Ottawa Hospital and Ottawa Hospital Research Institute;Division of Hematology, Albert Einstein College of Medicine and Montefiore Medical Center;Hematology Division, Brigham and Women's Hospital, Harvard Medical School;Memorial Sloan Kettering Cancer Center

关键词: Cancer-associated thrombosis;    Venous thromboembolism;    Malignancy;   

DOI  :  10.1002/onco.13570

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Malignancy is a significant risk factor for venous thromboembolism (VTE). It is estimated that up to 20% of patients with cancer may develop VTE at some time in their cancer journey. Cancer-associated VTE can lead to hospitalizations, morbidity, delayed cancer treatment, and mortality. The optimal prevention and management of cancer-associated thrombosis (CAT) is of utmost importance. Direct oral anticoagulants have been recommended as first-line therapy for VTE treatment in the general population and their efficacy has recently been demonstrated in the cancer population, leading to increased use. However, patients with cancer have unique challenges and comorbidities that can lead to increased risks and concerns with anticoagulation. Herein we will discuss commonly encountered challenges in patients with CAT, review available literature, and provide practice suggestions. Implications for Practice This article aims to specifically address cancer-associated thrombosis issues for which there is limited or absent evidence to guide best practice, for circumstances that pose unique challenges for clinicians, and for directions when the literature is conflicting. It reviews pertinent data for each selected topic and provides guidance for patient management based on the best available evidence and experiences from the panel.

【 授权许可】

CC BY|CC BY-NC