Low molecular heparin (Enoxaparin) as an alternative treatment of acute deep venous thrombosis in gynecologic oncology patients

Abstract

While heparin has been the standard treatment in established deep vein thrombosis (DVT), it carries associated potential hazards of hemorrhage and induction of thrombocytopenia. Enoxaparin (Rhone-Poulenc Rorer Pharm. Inc., France) is a low molecular weight heparin which has antithrombotic properties, and has been demonstrated effective in prophylaxis of DVT, apparently without severe treatment related bleeding complications. Six patients with genital malignancies, presenting with Doppler sonography confirmed deep venous thrombosis, were treated with Enoxaparin. A uniform dosage of 2 mg/kg/day in two divided doses was administered subcutaneously for 10 days during hospitalization and then continued on an out-patient basis. The clinical symptoms of venous thromboses diminished in all six patients. Enoxaparin represents an effective treatment of DVT, with the potential advantage of a lessening hemorrhagic complications. With administration of low molecular heparin, the activated partial thromboplastin time (aPTT) is not dramatically altered, making laboratory monitoring unnecessary. Our clinical findings demonstrate an easily applied therapy for gynecologic oncology patients, which is potentially safer to use, less costly, and less dependent on laboratory monitoring than the normal regimen.