Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;73(10):809-819.
doi: 10.1007/s00105-022-05056-8.

[Cancer-associated coagulation disorders]

[Article in German]
Minna Voigtländer  1 , Florian Langer  2
Affiliations

[Cancer-associated coagulation disorders]

[Article in German]
Minna Voigtländer et al. Dermatologie (Heidelb). 2022 Oct.

Abstract
in English, German

Diagnosis and treatment of paraneoplastic coagulation disorders are a challenge in daily practice. While prophylactic anticoagulation to prevent venous thromboembolism (VTE) is standard of care in all surgical and acutely ill medical cancer patients, particularly careful evaluation of risks and benefits using validated risk assessment models is required during outpatient chemotherapy. Low-molecular-weight heparin and direct oral factor Xa inhibitors are available to treat established cancer-associated VTE, adhering to algorithms for bleeding risk stratification. In patients with overt disseminated intravascular coagulation, therapeutic measures should strictly follow clinical symptoms. An acquired von Willebrand syndrome may evoke a severe bleeding tendency in patients with myeloproliferative neoplasms or plasma cell dyscrasias. In 15% of cases, acquired hemophilia A, due to the formation of inhibitory autoantibodies against coagulation factor VIII, is associated with malignancy.

Diagnostik und Therapie paraneoplastischer Gerinnungsstörungen stellen im Praxisalltag eine große Herausforderung dar. Während die prophylaktische Antikoagulation zur Vorbeugung einer venösen Thromboembolie (VTE) bei chirurgischen und akut erkrankten internistischen Tumorpatienten etablierter Standard ist, muss unter ambulanter Systemtherapie eine besonders sorgfältige Abwägung auf Basis validierter Risikomodelle erfolgen. Die Differenzialtherapie der krebsassoziierten VTE umfasst niedermolekulare Heparine und direkte orale Faktor-Xa-Inhibitoren. Bei disseminierter intravasaler Gerinnung richten sich die therapeutischen Maßnahmen strikt nach der klinischen Symptomatik. Das erworbene Von-Willebrand-Syndrom kann bei Patienten mit myeloproliferativen Neoplasien oder Plasmazellerkrankungen eine schwere Blutungsneigung hervorrufen. In 15 % der Fälle ist die erworbene Hämophilie A, verursacht durch inhibitorische Autoantikörper gegen Faktor VIII, mit einem Malignom assoziiert.

Keywords: Anticoagulants; Disseminated intravascular coagulation; Hemophilia A, acquired; Venous thromboembolism; Von Willebrand disease, acquired.

PubMed Disclaimer

Similar articles

See all similar articles

References

Literatur

    1. Langer F (2021) Malignomassoziierte venöse Thromboembolie. In: Klinische Angiologie. Springer, Berlin Heidelberg
    1. Farge D et al (2019) 2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. Lancet Oncol 20(10):e566–e581 - PubMed
    1. Key NS et al (2020) Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol 38(5):496–520 - PubMed
    1. Lyman GH et al (2021) American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer. Blood Adv 5(4):927–974 - PubMed - PMC
    1. Khorana AA et al (2008) Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 111(10):4902–4907 - PubMed - PMC

MeSH terms

LinkOut - more resources