title: Venous thromboembolism in the hematologic malignancies.
abstract: OBJECTIVE
  This review summarizes the current knowledge of the epidemiology, prophylaxis, and treatment of venous thromboembolism (VTE) in patients with lymphoma, multiple myeloma or acute leukemia.
  
  
  RESULTS
  Hematologic malignancies are associated with a high risk of thrombotic complications. The incidence of these events is greatly variable and is influenced by many factors, including the type and the stage of disease, antitumor therapies, and the use of central venous device (CVD). Epidemiological data allow an estimate of the incidence of VTE in acute leukemia, lymphomas, and multiple myeloma. The effect of chemotherapy on the incidence of thrombosis is particularly evident in acute leukemia as it causes the exacerbation of the clotting/bleeding syndrome typical of this disease. The role of chemotherapy is also relevant in lymphoma, and in multiple myeloma, in which the use of immunomodulating agents, in combination with chemotherapy and steroids significantly increases the risk of VTE.
  
  
  CONCLUSIONS
  Thrombotic complications have a significant impact on morbidity and mortality of hematological cancer patients, therefore, in this setting, the issue of thromboprophylaxis to prevent VTE is important. However, no clear recommendation in these conditions is available, with the exception of multiple myeloma. Large prospective randomized clinical trials are needed to establish the best practice for prevention and treatment of VTE in these types of malignant diseases.
authors.affiliation: Division of Immunohematology and Transfusion Medicine, Ospedali Riuniti di Bergamo, Bergamo, Italy. annafalanga@yahoo.com
authors.forename: Anna
authors.initials: A
authors.lastname: Falanga
authors.forename: Marina
authors.initials: M
authors.lastname: Marchetti
authors.forename: Laura
authors.initials: L
authors.lastname: Russo
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000150:complications* / Q000453:epidemiology; D008223:Lymphoma / Q000150:complications* / Q000453:epidemiology; D009101:Multiple Myeloma / Q000150:complications* / Q000453:epidemiology; D017713:Platelet Transfusion; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014812:Vitamin K