Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 1: prophylaxis.

Autor: Easaw JC; Alberta: Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Centre, Calgary (Easaw, Shea- Budgell); Cancer Strategic Clinical Network, Alberta Health Services, Calgary (Shea-Budgell); Division of Hematology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (Wu); Guideline Utilization Resource Unit, CancerControl Alberta, Alberta Health Services, Calgary (Meek)., Shea-Budgell MA; Alberta: Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Centre, Calgary (Easaw, Shea- Budgell); Cancer Strategic Clinical Network, Alberta Health Services, Calgary (Shea-Budgell); Division of Hematology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (Wu); Guideline Utilization Resource Unit, CancerControl Alberta, Alberta Health Services, Calgary (Meek)., Wu CM; Alberta: Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Centre, Calgary (Easaw, Shea- Budgell); Cancer Strategic Clinical Network, Alberta Health Services, Calgary (Shea-Budgell); Division of Hematology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (Wu); Guideline Utilization Resource Unit, CancerControl Alberta, Alberta Health Services, Calgary (Meek)., Czaykowski PM; Manitoba: Department of Medicine, University of Manitoba, Cancer Care Manitoba, Winnipeg (Czaykowski)., Kassis J; Quebec: Hôpital Maisonneuve-Rosemont, Montreal (Kassis); Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal (Tagalakis); Department of Oncology, Faculty of Medicine, McGill University, Montreal (Kavan)., Kuehl B; Ontario: Scientific Insights Consulting Group, Mississauga (Kuehl); Department of Medicine, St. Michael's Hospital Division of Nephrology, University of Toronto, Toronto (McFarlane); Department of Oncology, Western University, London (Welch)., Lim HJ; British Columbia: Department of Medical Oncology, BC Cancer Agency, Vancouver (Lim); BC Provincial Renal Agency and Faculty of Pharmaceutical Sciences, University of British Columbia and Royal Jubilee Hospital, Victoria (Martinusen)., MacNeil M; Nova Scotia: Department of Medicine, Dalhousie University, Halifax (MacNeil); Department of Medicine, Dalhousie University and Capital District Health Authority, Halifax (Shivakumar)., Martinusen D; British Columbia: Department of Medical Oncology, BC Cancer Agency, Vancouver (Lim); BC Provincial Renal Agency and Faculty of Pharmaceutical Sciences, University of British Columbia and Royal Jubilee Hospital, Victoria (Martinusen)., McFarlane PA; Ontario: Scientific Insights Consulting Group, Mississauga (Kuehl); Department of Medicine, St. Michael's Hospital Division of Nephrology, University of Toronto, Toronto (McFarlane); Department of Oncology, Western University, London (Welch)., Meek E; Alberta: Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Centre, Calgary (Easaw, Shea- Budgell); Cancer Strategic Clinical Network, Alberta Health Services, Calgary (Shea-Budgell); Division of Hematology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (Wu); Guideline Utilization Resource Unit, CancerControl Alberta, Alberta Health Services, Calgary (Meek)., Moodley O; Saskatchewan: Department of Medicine, Division of Hematology, University of Saskatchewan, Saskatoon (Moodley)., Shivakumar S; Nova Scotia: Department of Medicine, Dalhousie University, Halifax (MacNeil); Department of Medicine, Dalhousie University and Capital District Health Authority, Halifax (Shivakumar)., Tagalakis V; Quebec: Hôpital Maisonneuve-Rosemont, Montreal (Kassis); Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal (Tagalakis); Department of Oncology, Faculty of Medicine, McGill University, Montreal (Kavan)., Welch S; Ontario: Scientific Insights Consulting Group, Mississauga (Kuehl); Department of Medicine, St. Michael's Hospital Division of Nephrology, University of Toronto, Toronto (McFarlane); Department of Oncology, Western University, London (Welch)., Kavan P; Quebec: Hôpital Maisonneuve-Rosemont, Montreal (Kassis); Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal (Tagalakis); Department of Oncology, Faculty of Medicine, McGill University, Montreal (Kavan).
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2015 Apr; Vol. 22 (2), pp. 133-43.
DOI: 10.3747/co.22.2586
Abstrakt: Patients with cancer are at increased risk of venous thromboembolism (vte). Anticoagulation therapy has been shown to prevent vte; however, unique clinical circumstances in patients with cancer can often complicate the decisions surrounding the administration of prophylactic anticoagulation. No national Canadian guidelines on the prevention of cancer-associated thrombosis have been published. We therefore aimed to develop a consensus-based, evidence-informed guideline on the topic. PubMed was searched for clinical trials and meta-analyses published between 2002 and 2013. Reference lists of key articles were hand-searched for additional publications. Content experts from across Canada were assembled to review the evidence and make recommendations. Low molecular weight heparin can be used prophylactically in cancer patients at high risk of developing vte. Direct oral anticoagulants are not recommended for vte prophylaxis at this time. Specific clinical scenarios, including renal insufficiency, thrombocytopenia, liver disease, and obesity can warrant modifications in the administration of prophylactic anticoagulant therapy. There is no evidence to support the monitoring of anti-factor Xa levels in clinically stable cancer patients receiving prophylactic anticoagulation; however, factor Xa levels could be checked at baseline and periodically in patients with renal insufficiency. The use of anticoagulation therapy to prolong survival in cancer patients without the presence of risk factors for vte is not recommended.
Databáze: MEDLINE
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