The role of thromboprophylaxis in cancer patients: emerging data.
OBJECTIVE
Venous thromboembolism (VTE) is a frequent cause of morbidity and mortality in cancer patients. A significant proportion of cancer-associated VTE occurs in the ambulatory setting and is associated with poorer outcomes and reduced survival. Risk for VTE is influenced by patient, cancer and treatment-specific factors.


RESULTS
Recent studies have identified biomarkers associated with increased VTE risk in malignancy, including leukocyte and platelet counts, tissue factor, prothrombin split products, D-dimer, P-selectin, factor VIII and C-reactive protein. Recent and ongoing clinical trials have focused on VTE prophylaxis with low-molecular weight heparins in high-risk cancer outpatients, particularly those with pancreatic cancer. These studies have yielded encouraging preliminary results but whether thromboprophylaxis provides significant benefit to unselected cancer outpatients remains unclear.


CONCLUSIONS
A risk stratification model incorporating known risk factors and biomarkers can identify those patients at highest risk. This review focuses on emerging data regarding risk assessment and benefit of thromboprophylaxis in patients with cancer.
Menapace
Laurel A
LA
James P. Wilmot Cancer Center, Department of Medicine, University of Rochester, Rochester, New York 14642, USA.
Khorana
Alok A
AA
D015415:Biomarkers / Q000097:blood; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*
D015415:Biomarkers; D005343:Fibrinolytic Agents