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https://www.readbyqxmd.com/read/27913481/anti-xa-monitoring-of-low-molecular-weight-heparin-in-adult-patients-with-cancer
#1
Lisa Baumann Kreuziger, Michael Streiff
A 68-year-old man developed a right femoral vein deep vein thrombosis and bilateral pulmonary embolism while receiving chemotherapy for stage IV prostate cancer. His creatinine at diagnosis is 1.4 mg/dL, with an estimated clearance of 63 mL/min. In patients with cancer, should low-molecular-weight heparin treatment be dosed according to weight, or adjusted using anti-Xa levels?
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913480/thrombosis-in-the-setting-of-cancer
#2
Michael B Streiff
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...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27906452/primary-prophylaxis-for-venous-thromboembolism-in-ambulatory-cancer-patients-receiving-chemotherapy
#3
REVIEW
Marcello Di Nisio, Ettore Porreca, Matteo Candeloro, Michele De Tursi, Ilaria Russi, Anne Ws Rutjes
BACKGROUND: Venous thromboembolism (VTE) often complicates the clinical course of cancer. The risk is further increased by chemotherapy, but the trade-off between safety and efficacy of primary thromboprophylaxis in cancer patients treated with chemotherapy is uncertain. This is the second update of a review first published in February 2012. OBJECTIVES: To assess the efficacy and safety of primary thromboprophylaxis for VTE in ambulatory cancer patients receiving chemotherapy compared with placebo or no thromboprophylaxis...
December 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27895068/impact-of-a-dedicated-cancer-associated-thrombosis-service-on-clinical-outcomes-a-mixed-methods-evaluation-of-a-clinical-improvement-exercise
#4
Simon Noble, Nikki Pease, Jessica Sui, James Davies, Sarah Lewis, Usman Malik, Raza Alikhan, Hayley Prout, Annmarie Nelson
OBJECTIVES: Cancer-associated thrombosis (CAT) complex condition, which may present to any healthcare professional and at any point during the cancer journey. As such, patients may be managed by a number of specialties, resulting in inconsistent practice and suboptimal care. We describe the development of a dedicated CAT service and its evaluation. SETTING: Specialist cancer centre, district general hospital and primary care. PARTICIPANTS: Patients with CAT and their referring clinicians...
November 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27882374/cancer-associated-venous-thromboembolism-burden-mechanisms-and-management
#5
Cihan Ay, Ingrid Pabinger, Alexander T Cohen
Venous thromboembolism (VTE) is a significant health problem in the general population but especially in cancer patients. In this review, we discuss the epidemiology and burden of the disease, the pathophysiology of cancer-associated VTE, and the clinical treatment options for both primary prevention and acute treatment. Overall, the development of VTE in cancer patients is related to increases in morbidity, mortality, and medical costs. However, the incidence of cancer-associated VTE varies due to patient-related factors (e...
November 24, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27869512/controversies-in-the-management-of-cancer-associated-thrombosis
#6
Marc Carrier, Paolo Prandoni
Cancer associated thrombosis (CAT) is a frequent complication among cancer patients. It is associated with increased morbidity, mortality, and psychological burden. Areas covered: Low-molecular-weight heparin monotherapy for the initial 6 months is considered the standard of care for the acute and long-term management of CAT. For patients at high risk of recurrent CAT (e.g. active cancer or still undergoing anticancer therapy) beyond the initial 6 months of treatment, continuation of anticoagulation therapy for secondary prevention is usually recommended...
November 21, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27849664/perioperative-pharmacological-thromboprophylaxis-in-patients-with-cancer-a-systematic-review-and-meta-analysis
#7
Qiang Guo, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Xiaojiong Du
OBJECTIVE: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation. BACKGROUND: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management. METHODS: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27836513/anticoagulant-therapy-for-symptomatic-calf-deep-vein-thrombosis-cactus-a-randomised-double-blind-placebo-controlled-trial
#8
Marc Righini, Jean-Philippe Galanaud, Hervé Guenneguez, Dominique Brisot, Antoine Diard, Pascale Faisse, Marie-Thérèse Barrellier, Claudine Hamel-Desnos, Christine Jurus, Olivier Pichot, Myriam Martin, Lucia Mazzolai, Clarisse Choquenet, Sandrine Accassat, Helia Robert-Ebadi, Marc Carrier, Grégoire Le Gal, Bernadette Mermilllod, Jean-Pierre Laroche, Henri Bounameaux, Arnaud Perrier, Susan R Kahn, Isabelle Quere
BACKGROUND: The efficacy and safety of anticoagulant treatment is not established for patients with acute symptomatic deep vein thrombosis (DVT) of the calf. We aimed to assess whether therapeutic anticoagulation is superior to placebo in patients with symptomatic calf DVT. METHODS: In this randomised, double-blind, placebo-controlled trial, we enrolled low-risk outpatients (without active cancer or previous venous thromboembolic disease) with a first acute symptomatic DVT in the calf from 23 university medical centres or community medical clinics in Canada, France, and Switzerland...
November 7, 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27829872/noninvasive-prenatal-testing-for-aneuploidy-using-cell-free-dna-new-implications-for-maternal-health
#9
REVIEW
Lisa Hui
The rapid global uptake of noninvasive prenatal testing for Down syndrome based on maternal plasma cell-free DNA has provided new data on the interrelationship between cell-free DNA and maternal health. Specific maternal conditions that can affect the performance of noninvasive prenatal testing include obesity, active autoimmune disease and low molecular weight heparin treatment. There is also a growing appreciation of the implications of discordant noninvasive prenatal testing results for maternal health, including unexpected diagnoses of maternal chromosomal conditions, or rarely, occult cancer...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27807505/implantable-port-thrombosis-in-cancer-patients-a-monocentric-experience
#10
Manel Dridi, Nesrine Mejri, Soumaya Labidi, Mehdi Afrit, Houda El Benna, Khaoula Ben Miled, Hamouda Boussen
OBJECTIVE: Implantable port thrombosis (IPT) in cancer patients is a relatively rare but severe complication. Several factors are reportedly associated with the occurrence of thrombosis. We aimed to describe the prevalence and the anatomoclinical features of IPT observed in cancer patients who were treated in a medical oncology department in Tunisia. METHODS: A total of 600 cancer patients who had port implantation from January 2013 to December 2015 were retrospectively identified...
September 2016: Cancer Biology & Medicine
https://www.readbyqxmd.com/read/27766052/cancer-associated-thrombosis-in-asia
#11
Pantep Angchaisuksiri
Thrombosis is a common complication in cancer patients. Although the major inherited risk factors for thrombophilia are different between Asians and Caucasians, the main acquired risk factors that are associated with the development of venous thromboembolism (VTE) in Asians appear to be similar to those for Caucasians. Malignancy is the most important acquired risk factor for VTE in Asians. Recent studies have shown that the incidence of VTE is significant in Asian patients with cancer, particularly those in an advanced stage...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#12
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27721250/adjuvant-therapy-with-heparin-in-patients-with-lung-cancer-without-indication-for-anticoagulants-a-systematic-review-of-the-literature-with-meta-analysis
#13
Yuman Yu, Qun Lv, Bin Zhang, Fen Lan, Yifan Dai
BACKGROUND: The effect of heparin in improving cancer survival has gained increasing attention over the past decades. Several clinical trials have evaluated the role of heparin on survival outcome and its safety profile in lung cancer patients. Thus, we performed a systematic review and meta-analysis from the results of randomized controlled trials (RCTs) to assess the efficacy and safety of heparin in patients with lung cancer without indication for anticoagulants. METHODS: We searched PubMed, Embase, and The Cochrane Central Register of Controlled Trials databases for relevant studies...
October 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/27704333/risk-of-intracranial-hemorrhage-associated-with-therapeutic-anticoagulation-for-venous-thromboembolism-in-cancer-patients-a-systematic-review-and-meta-analysis
#14
Cristhiam M Rojas-Hernandez, Thein Hlaing Oo, Herney Andrés García-Perdomo
Intracranial hemorrhage (ICH) in cancer patients can result from tumor bleeding and from antitumor and anticoagulation therapy. The effect of anticoagulation on the incidence of ICH in cancer patients has not been quantified. Our objective was to determine the risk of intracranial hemorrhage associated with anticoagulation therapy for cancer-associated venous thromboembolism (VTE). Systematic review and meta-analysis of studies assessing the safety of anticoagulation therapy in patients with cancer-associated VTE...
October 4, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27701688/-direct-oral-anticoagulants-doac-in-tumor-patients
#15
Ralf Ulrich Trappe, Marianne Sinn, Hanno Riess
There is only limited data for the use of direct oral anticoagulants (DOACs) in tumor patients and no data from prospective randomised trials comparing DOACs to the current standard care: low molecular weight heparine (LMWH). Therefore, DOACs must be used with caution and should be restricted to tumor patients with (1) contraindications for LMWH (e.g. HIT II, phobia of syringe) or (2) to the situations of prolonged anticoagulation after initial therapy with LMWH. Cancer-associated disorders as well as side effects of chemotherapy as nausea and emesis have to be considered as well as potential substance-specific interactions...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27696084/safe-and-effective-use-of-rivaroxaban-for-treatment-of-cancer-associated-venous-thromboembolic-disease-a-prospective-cohort-study
#16
Simon Mantha, Eva Laube, Yimei Miao, Debra M Sarasohn, Rekha Parameswaran, Samantha Stefanik, Gagandeep Brar, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff
Low-molecular weight heparin (LMWH) has been the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. Rivaroxaban was approved in 2012 for the treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT), but no prior studies have been reported specifically evaluating the efficacy and safety of rivaroxaban for cancer-associated thrombosis (CAT). Under a Quality Assessment Initiative (QAI), we established a Clinical Pathway to guide rivaroxaban use for CAT and now report a validation analysis of our first 200 patients...
September 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27688212/patient-adherence-and-experience-with-extended-use-of-prophylactic-low-molecular-weight-heparin-following-pancreas-and-liver-resection
#17
Madeline Lemke, Kaitlyn Beyfuss, Julie Hallet, Natalie G Coburn, Calvin H L Law, Paul J Karanicolas
BACKGROUND: Guidelines recommend 28 days venous thromboembolism (VTE) prophylaxis with low-molecular-weight heparin (LMWH) following major abdominal surgery for cancer. Overall adherence with these recommendations is poor, but little is known about feasibility and tolerability from a patient perspective. METHODS: An institution-wide policy for routine administration of 28 days of post-operative LMWH following major hepatic or pancreatic resection for cancer was implemented in April 2013...
September 29, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27652114/venous-thromboembolism-prophylaxis-in-patients-undergoing-abdominal-and-pelvic-cancer-surgery-adherence-and-compliance-to-accp-guidelines-in-dionys-registry
#18
Negib Geahchan, Melkart Basile, Maroon Tohmeh
BACKGROUND: Venous thromboembolism (VTE) is a major health care problem resulting in significant mortality, morbidity and increase in medical expenses. Patients with malignant diseases represent a high risk population for VTE. The American College of Chest Physicians (ACCP) proposed, since 1986, prophylaxis guidelines that are unequally respected in surgical practice. METHODS: DIONYS is a multinational, longitudinal and non-interventional registry including patients having undergone abdominal or pelvic surgery for cancer in Latin America, Africa and the Middle East...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27651974/successful-deep-inferior-epigastric-perforator-flap-harvest-despite-preoperative-therapeutic-subcutaneous-heparin-administration-into-the-abdominal-pannus
#19
Joseph W Duncumb, Kana Miyagi, Parto Forouhi, Charles M Malata
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27623682/spotlight-on-advances-in-vte-management-callisto-and-einstein-choice
#20
Miriam Bach, Rupert Bauersachs
Venous thromboembolism (VTE) is associated with numerous complications and high mortality rates. Patients with cancer are at high risk of developing cancer-associated thrombosis (CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in patients with cancer is lacking - direct comparisons between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported outcomes. Cancer Associated thrombosis - expLoring soLutions for patients through Treatment and Prevention with RivarOxaban (CALLISTO) is an international research programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban for the prevention and treatment of CAT, supplementing existing data from EINSTEIN DVT and EINSTEIN PE...
September 28, 2016: Thrombosis and Haemostasis
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