A critical balance: managing coagulation in patients with glioma.
Cancer-associated thrombosis, including both arterial and venous thromboembolism (VTE), is a significant source of morbidity and mortality in patients with glioma. This risk is highest in the immediate postoperative period and is increased by chemotherapy, radiation, and corticosteroids. Systemic anticoagulation with low molecular weight heparin is the treatment of choice in both the therapeutic and prophylactic settings. However, these patients are also at risk of intracranial hemorrhage, a potentially catastrophic complication of anticoagulation, and this risk must be carefully balanced against the risk of VTE. In this review we outline the incidence, pathophysiology and management of thrombosis in patients with glioma, with a focus on clinical considerations including perioperative management, chemotherapy-induced thrombocytopenia, and end-of-life management.
a Pencer Brain Tumor Centre , Princess Margaret Hospital Cancer Centre , Toronto , Canada.|b Department of Medical Oncology and Hematology , University of Toronto , Toronto , Canada.
Erin R
ER
Morgan
a Pencer Brain Tumor Centre , Princess Margaret Hospital Cancer Centre , Toronto , Canada.|b Department of Medical Oncology and Hematology , University of Toronto , Toronto , Canada.
Warren P
WP
Mason
a Pencer Brain Tumor Centre , Princess Margaret Hospital Cancer Centre , Toronto , Canada.|b Department of Medical Oncology and Hematology , University of Toronto , Toronto , Canada.
Catherine
C
Maurice
D000925:Anticoagulants / Q000627:therapeutic use; D005910:Glioma / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D054556:Venous Thromboembolism
D000925:Anticoagulants
Anticoagulation brain tumor; glioma; hemorrhage; stroke; therapy