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Review
. 2016 Dec 2;2016(1):196-205.
doi: 10.1182/asheducation-2016.1.196.

Thrombosis in the setting of cancer

Michael B Streiff  1
Affiliations
Review

Thrombosis in the setting of cancer

Michael B Streiff. Hematology Am Soc Hematol Educ Program. .

Abstract

Venous thromboembolism (VTE) is a common cause of adverse outcomes in patients with cancer. The risk of VTE varies with cancer type, stage and grade, cancer therapy, and supportive care, as well as patient characteristics including age, ethnicity, and inherited and acquired comorbid conditions. VTE prophylaxis should be provided to all hospitalized cancer patients and high-risk outpatients. Low-molecular-weight heparin (LMWH) remains the first-line therapy for VTE in patients with active cancer. Anticoagulation should be continued as long as there is evidence of active disease or patients are receiving cancer treatment. The efficacy of direct oral anticoagulants in the treatment of cancer-associated thrombosis remains incompletely defined. Central venous catheter (CVC)-associated VTE should be treated with anticoagulation alone, unless the CVC is no longer required. Recent studies indicate that anticoagulation may be appropriate for patients with persistent thrombocytopenia or solid tumor brain metastases. Management of recurrent VTE includes the identification of the cause(s) of the recurrence and solutions targeted at addressing the potential precipitants.

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Conflict of interest statement

Conflict-of-interest disclosure: The author has received research funding from Janssen, Portola, Roche, and the Patient-Centered Outcomes Research Institute, and has consulted for Bio2 Medical, Janssen, CSL Behring, and Merck.

Figures

Figure 1.
Figure 1.
Approach to the cancer patient with recurrent VTE.
See this image and copyright information in PMC

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