title: Complications and failure of anticoagulation therapy in the treatment of venous thromboembolism in patients with disseminated malignancy.
abstract: Thirty-one patients with malignancy, anticoagulated for the treatment of venous thromboembolism (VTE) are reported. Complications of treatment included major bleeding (35%), redevelopment of VTE whilst on therapeutic levels of anticoagulants (13%) and recurrent VTE following cessation of anticoagulant (42%). Forty-two per cent of patients died within three months of initiating anticoagulant therapy. The cause of death was progressive malignancy, except in one patient who died of anticoagulant-related bleeding. The high incidence of bleeding is frequently associated with over-anticoagulation and indicates the need for improved monitoring. The frequent recurrence of VTE is associated with chronic disseminated intravascular coagulation, for which warfarin is ineffective and heparin is indicated.
authors.affiliation: Austin Hospital, Heidelberg, Vic.
authors.forename: A
authors.initials: A
authors.lastname: Chan
authors.forename: R K
authors.initials: RK
authors.lastname: Woodruff
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009369:Neoplasms / Q000150:complications*; D012008:Recurrence; D013923:Thromboembolism / Q000188:drug therapy* / Q000209:etiology; D013924:Thrombophlebitis / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D014859:Warfarin; D006493:Heparin