[Actual questions about the prevention of venous thromboembolism in cancer patients receiving chemotherapy].
Cancer patients have a 2-7 fold increased risk of venous thromboembolism compared with the general population and, since 1990, this is associated with significant morbidity and mortality. This review summarizes the current knowledge on venous thromboembolism and cancer. Notably, the risk of venous thromboembolism varies depending on the type and stage of cancer. For instance, pancreatic and brain cancer patients have a higher risk of venous thromboembolism than breast and prostate cancer patients. Moreover, patients with metastatic disease have a higher risk than those with localized tumors. Tumor-derived procoagulant factors, cytokines and growth factors may directly and indirectly enhance venous thromboembolism. Chemotherapy produces ~6,5 fold increase in venous thromboembolism incidence in cancer patients compared to the general population. Prevention of this complication is challenging. The authors review the development of guidelines concerning venous thromboembolism prevention in hospitalized and also in ambulatory cancer patients treated with chemotherapy. Current guidelines recommend the use of low-molecular-weight heparin. Understanding the underlying mechanisms may allow the development of new therapies to safely prevent venous thromboembolism in cancer patients.
Klinikai Központ, I. Belgyógyászati Klinika, Haematologia, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs, Ifjúság útja 13., 7624.
Hajna
H
Losonczy
Klinikai Központ, I. Belgyógyászati Klinika, Haematologia, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs, Ifjúság útja 13., 7624.
Ágnes
Á
Nagy
Vasútegészségügyi Nonprofit Közhasznú Kft. Budapest.
Attila
A
Tar
D000925:Anticoagulants / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D019317:Evidence-Based Medicine; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000188:drug therapy*; D010045:Outpatients; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000139:chemically induced / Q000209:etiology* / Q000517:prevention & control*
D000925:Anticoagulants; D000970:Antineoplastic Agents; D015415:Biomarkers; D006495:Heparin, Low-Molecular-Weight
cancer and thrombosis; chemotherapy; kemoterápia; tumorok és thrombosis; venous thromboembolism prevention; vénásthromboembolia-profilaxis