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Management of cancer-associated venous thromboembolism - a case-based practical approach

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Management of cancer-associated venous thromboembolism - a case-based practical approach. / Voigtlaender, Minna; Langer, Florian.

In: VASA, Vol. 47, No. 2, 02.2018, p. 77-89.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Voigtlaender, M & Langer, F 2018, 'Management of cancer-associated venous thromboembolism - a case-based practical approach', VASA, vol. 47, no. 2, pp. 77-89. https://doi.org/10.1024/0301-1526/a000684

APA

Voigtlaender, M., & Langer, F. (2018). Management of cancer-associated venous thromboembolism - a case-based practical approach. VASA, 47(2), 77-89. https://doi.org/10.1024/0301-1526/a000684

Vancouver

Voigtlaender M, Langer F. Management of cancer-associated venous thromboembolism - a case-based practical approach. VASA. 2018 Feb;47(2):77-89. https://doi.org/10.1024/0301-1526/a000684

Bibtex

@article{c35c87258aaa4bf6a3d6329a623747c5,
title = "Management of cancer-associated venous thromboembolism - a case-based practical approach",
abstract = "In patients with solid tumours or haematological malignancies, venous thromboembolism (VTE) is a leading cause of death and significantly contributes to morbidity and healthcare resource utilization. Current practice guidelines recommend long-term anticoagulation with low-molecular-weight heparin (LMWH) as the treatment of choice for cancer-associated VTE, based on clinical trial data showing an overall improved safety and efficacy profile of LMWH compared to vitamin K antagonists. However, several open questions remain, e. g. with regard to the intensity and duration of LMWH therapy; moreover, recent real-world evidence indicates that adherence to parenteral anticoagulation with LMWH over the course of treatment is poor in clinical practice. In this regard, the direct oral factor Xa or thrombin inhibitors (DOACs) have emerged as potential alternatives in the management of patients with cancer-associated VTE, albeit findings from randomized controlled studies with a direct head-to-head comparison of DOACs with LMWH, the current standard of care, are still lacking. Based on the case of a lymphoma patient experiencing symptomatic pulmonary embolism during immunochemotherapy, this article aims at both highlighting the current state-of-the-art approach to cancer-associated VTE and pointing out some of the unresolved, controversial issues clinicians have to face when taking care of haematology and oncology patients with already established or with high risk of developing VTE. These issues include the management of patients with incidental pulmonary embolism or thrombocytopenia, the use of DOACs, and the initiation of pharmacological thromboprophylaxis in non-surgical cancer patients.",
keywords = "Administration, Oral, Anticoagulants, Blood Coagulation, Computed Tomography Angiography, Drug Administration Schedule, Drug Interactions, Duodenal Neoplasms, Endoscopy, Gastrointestinal, Fibrinolytic Agents, Hemorrhage, Humans, Lymphoma, Male, Medication Adherence, Middle Aged, Pulmonary Embolism, Risk Factors, Treatment Outcome, Venous Thromboembolism, Venous Thrombosis, Case Reports, Journal Article, Review",
author = "Minna Voigtlaender and Florian Langer",
year = "2018",
month = feb,
doi = "10.1024/0301-1526/a000684",
language = "English",
volume = "47",
pages = "77--89",
journal = "VASA",
issn = "0301-1526",
publisher = "Hans Huber",
number = "2",

}

RIS

TY - JOUR

T1 - Management of cancer-associated venous thromboembolism - a case-based practical approach

AU - Voigtlaender, Minna

AU - Langer, Florian

PY - 2018/2

Y1 - 2018/2

N2 - In patients with solid tumours or haematological malignancies, venous thromboembolism (VTE) is a leading cause of death and significantly contributes to morbidity and healthcare resource utilization. Current practice guidelines recommend long-term anticoagulation with low-molecular-weight heparin (LMWH) as the treatment of choice for cancer-associated VTE, based on clinical trial data showing an overall improved safety and efficacy profile of LMWH compared to vitamin K antagonists. However, several open questions remain, e. g. with regard to the intensity and duration of LMWH therapy; moreover, recent real-world evidence indicates that adherence to parenteral anticoagulation with LMWH over the course of treatment is poor in clinical practice. In this regard, the direct oral factor Xa or thrombin inhibitors (DOACs) have emerged as potential alternatives in the management of patients with cancer-associated VTE, albeit findings from randomized controlled studies with a direct head-to-head comparison of DOACs with LMWH, the current standard of care, are still lacking. Based on the case of a lymphoma patient experiencing symptomatic pulmonary embolism during immunochemotherapy, this article aims at both highlighting the current state-of-the-art approach to cancer-associated VTE and pointing out some of the unresolved, controversial issues clinicians have to face when taking care of haematology and oncology patients with already established or with high risk of developing VTE. These issues include the management of patients with incidental pulmonary embolism or thrombocytopenia, the use of DOACs, and the initiation of pharmacological thromboprophylaxis in non-surgical cancer patients.

AB - In patients with solid tumours or haematological malignancies, venous thromboembolism (VTE) is a leading cause of death and significantly contributes to morbidity and healthcare resource utilization. Current practice guidelines recommend long-term anticoagulation with low-molecular-weight heparin (LMWH) as the treatment of choice for cancer-associated VTE, based on clinical trial data showing an overall improved safety and efficacy profile of LMWH compared to vitamin K antagonists. However, several open questions remain, e. g. with regard to the intensity and duration of LMWH therapy; moreover, recent real-world evidence indicates that adherence to parenteral anticoagulation with LMWH over the course of treatment is poor in clinical practice. In this regard, the direct oral factor Xa or thrombin inhibitors (DOACs) have emerged as potential alternatives in the management of patients with cancer-associated VTE, albeit findings from randomized controlled studies with a direct head-to-head comparison of DOACs with LMWH, the current standard of care, are still lacking. Based on the case of a lymphoma patient experiencing symptomatic pulmonary embolism during immunochemotherapy, this article aims at both highlighting the current state-of-the-art approach to cancer-associated VTE and pointing out some of the unresolved, controversial issues clinicians have to face when taking care of haematology and oncology patients with already established or with high risk of developing VTE. These issues include the management of patients with incidental pulmonary embolism or thrombocytopenia, the use of DOACs, and the initiation of pharmacological thromboprophylaxis in non-surgical cancer patients.

KW - Administration, Oral

KW - Anticoagulants

KW - Blood Coagulation

KW - Computed Tomography Angiography

KW - Drug Administration Schedule

KW - Drug Interactions

KW - Duodenal Neoplasms

KW - Endoscopy, Gastrointestinal

KW - Fibrinolytic Agents

KW - Hemorrhage

KW - Humans

KW - Lymphoma

KW - Male

KW - Medication Adherence

KW - Middle Aged

KW - Pulmonary Embolism

KW - Risk Factors

KW - Treatment Outcome

KW - Venous Thromboembolism

KW - Venous Thrombosis

KW - Case Reports

KW - Journal Article

KW - Review

U2 - 10.1024/0301-1526/a000684

DO - 10.1024/0301-1526/a000684

M3 - SCORING: Review article

C2 - 29325495

VL - 47

SP - 77

EP - 89

JO - VASA

JF - VASA

SN - 0301-1526

IS - 2

ER -