title: Antithrombotic therapy in patients with thrombocytopenic cancer: outcomes associated with reduced-dose, low-molecular-weight heparin during hospitalization.
abstract: BACKGROUND
  Guidelines are discordant concerning management of patients having thrombocytopenia with cancer-associated thrombosis (CAT).
  
  
  METHODS
  Hospitalized adults with CAT and platelets ≤50 × 10(9) cells/L were managed with dalteparin 100 units/kg subcutaneously once daily. Comparator patients with CAT and platelets >50 × 10(9) cells/L were managed with dalteparin 200 units/kg/d.
  
  
  RESULTS
  Outcomes of 35 patients with thrombocytopenia (mean platelet count 26 ± 8.3 × 10(9) cells/L) and 58 comparator patients (mean platelet count 155 ± 75 × 10(9) cells/L) were evaluated. In all, 2 (5.7%) patients in the thrombocytopenia group and 1 patient (1.9%) in the comparator group experienced new-onset venous thromboembolism (odds ratio 3.31, 95% confidence interval [CI] 0.29-37.90, P = .556). The incidence of bleeding in patients with thrombocytopenia (8.6%) was similar to that in comparator patients (9.4%; risk ratio 0.94, 95% CI 0.37-2.39, P = .607).
  
  
  CONCLUSIONS
  In hospitalized patients having thrombocytopenia with CAT, reduced-dose low-molecular-weight heparin was generally efficacious.
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Babilonia
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA University of Colorado Health Sciences Library/Center for Drug Information, Education and Evaluation, Aurora, CO, USA larry.golightly@uchealth.org.
authors.forename: Larry K
authors.initials: LK
authors.lastname: Golightly
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Medicine, Divisions of Hematology and Blood Cancer/Bone Marrow Transplant, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Gutman
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Medicine, Divisions of Hematology and Blood Cancer/Bone Marrow Transplant, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Hassell
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Kaiser
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
authors.forename: Tyree H
authors.initials: TH
authors.lastname: Kiser
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Klem
authors.affiliation: University of Colorado Hospital, Aurora, CO, USA Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
authors.forename: Toby C
authors.initials: TC
authors.lastname: Trujillo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D017985:Dalteparin / Q000008:administration & dosage*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications*; D013921:Thrombocytopenia / Q000188:drug therapy*; D013927:Thrombosis / Q000188:drug therapy*
chemical_list: D005343:Fibrinolytic Agents; D017985:Dalteparin
keywords: anticoagulation; cancer; dalteparin; thrombocytopenia