title: Safety of anticoagulant treatment in cancer patients.
abstract: BACKGROUND
  Patients with cancer are at increased risk of (recurrent) venous thromboembolism. They are also at increased risk of bleeding. This makes treatment of venous thromboembolisms (VTE) in cancer patients challenging.
  
  
  METHODS
  In this review, we will focus on the safety of anticoagulant treatment of VTE in cancer patients. We will discuss the absolute and relative bleeding risks associated with the various types of anticoagulants, specifically focusing on low-molecular-weight heparins (LMWH), vitamin K antagonist (VKA) and the new oral anticoagulants (NOACs).
  
  
  CONCLUSIONS
  Monotherapy with LMWH is recommended for treatment of acute VTE in cancer patients. The bleeding risk associated with LMWH is comparable to VKAs, but LMWH are more effective in preventing recurrent VTE. More evidence on the efficacy and safety of NOACs in cancer patients is needed.
authors.affiliation: University Medical Center Groningen, Department of Vascular Medicine , Hanzeplein 1, 9700 GZ Groningen , The Netherlands +31 50 36 12943 ; +31 50 36 19069 ; i.t.wilts@umcg.nl.
authors.forename: Ineke Theodora
authors.initials: IT
authors.lastname: Wilts
authors.forename: Suzanne Mariëlla
authors.initials: SM
authors.lastname: Bleker
authors.forename: Nick
authors.initials: N
authors.lastname: Van Es
authors.forename: Harry Roger
authors.initials: HR
authors.lastname: Büller
authors.forename: Marcello
authors.initials: M
authors.lastname: Di Nisio
authors.forename: Pieter Willem
authors.initials: PW
authors.lastname: Kamphuisen
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D012008:Recurrence; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014812:Vitamin K
keywords: anticoagulant treatment; bleeding; cancer; low-molecular-weight heparins,; new oral anticoagulants,; venous thromboembolism; vitamin k antagonists