Venous thromboembolism in malignant gliomas.
Malignant gliomas are associated with a very high risk of venous thromboembolism (VTE). While many clinical risk factors have previously been described in brain tumor patients, the risk of VTE associated with newer anti-angiogenic therapies such as bevacizumab in these patients remains unclear. When VTE occurs in this patient population, concern regarding the potential for intracranial hemorrhage complicates management decisions regarding anticoagulation, and these patients have a worse prognosis than their VTE-free counterparts. Risk stratification models identifying patients at high risk of developing VTE along with predictive plasma biomarkers may guide the selection of eligible patients for primary prevention with pharmacologic thromboprophylaxis. Recent studies exploring disordered coagulation, such as increased expression of tissue factor (TF), and tumorigenic molecular signaling may help to explain the increased risk of VTE in patients with malignant gliomas.
Jenkins
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Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
Schiff
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D
Mackman
N
N
Key
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NS
D020533:Angiogenesis Inhibitors / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D001777:Blood Coagulation; D016543:Central Nervous System Neoplasms / Q000097:blood / Q000150:complications* / Q000628:therapy; D003131:Combined Modality Therapy; D005910:Glioma / Q000097:blood / Q000150:complications* / Q000628:therapy; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D020300:Intracranial Hemorrhages / Q000139:chemically induced; D019635:Neurosurgical Procedures / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D053828:Stockings, Compression; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology* / Q000517:prevention & control
D020533:Angiogenesis Inhibitors; D000925:Anticoagulants