title: Patterns of Venous Thromboembolism Prophylaxis During Treatment of Acute Leukemia: Results of a North American Web-Based Survey.
abstract: BACKGROUND
  Venous thromboembolism (VTE) occurs in 2% to 12% of patients with acute leukemia (AL) despite disease- and therapy-associated thrombocytopenia, and it can be associated with significant morbidity and mortality. Because of the few high-quality studies, there are no evidence-based guidelines for VTE prophylaxis in this patient population. We sought to determine the spectrum of practice regarding prevention of VTE in patients with AL during induction and consolidation therapies.
  
  
  METHODS
  We conducted a 19-question Web-based survey directed at North American providers caring for these patients. One hundred fifty-one of 215 responses received were eligible for analysis, with a response rate of 20.9% among physicians who treated leukemias.
  
  
  RESULTS
  Overall, 47% and 45% of providers reported using pharmacologic VTE prophylaxis during induction and consolidation phases, respectively. Approximately 15% of providers did not provide any VTE prophylaxis, while 36% used mechanical methods and ambulation. Among providers who did not recommend pharmacologic prophylaxis, the most commonly cited reasons were the perceived high risk of bleeding (51%), absence of data supporting use (38%), and perceived low risk of VTE (11%).
  
  
  CONCLUSIONS
  Large, prospective studies are needed to define the safest and most effective approach to VTE prevention in patients with AL.
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Eun-Ju
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Oncology, Johns Hopkins University, Baltimore, MD.
authors.forename: B Douglas
authors.initials: BD
authors.lastname: Smith
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Jessica W
authors.initials: JW
authors.lastname: Merrey
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Lee
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Nikolai A
authors.initials: NA
authors.lastname: Podoltsev
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Lisa
authors.initials: L
authors.lastname: Barbarotta
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Thomas
authors.initials: T
authors.lastname: Prebet
authors.affiliation: Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, PA.
authors.forename: Selina M
authors.initials: SM
authors.lastname: Luger
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Steven
authors.initials: S
authors.lastname: Gore
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Streiff
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT. Electronic address: amer.zeidan@yale.edu.
authors.forename: Amer M
authors.initials: AM
authors.lastname: Zeidan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D014481:United States; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents
keywords: Acute leukemia; Acute lymphoid leukemia; Acute myeloid leukemia; Deep venous thrombosis; Patterns of practice