Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update 2014
Metadatos
Mostrar el registro completo del ítemEditorial
10.1200/JCO.2014.59.7351
Fecha
2015-02-20Referencia bibliográfica
Lyman GH, Bohlke K, Khorana AA, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: american society of clinical oncology clinical practice guideline update 2014. J Clin Oncol. 2015;33(6): 654-656. [doi:10.1200/JCO.2014.59.7351]
Patrocinador
Amgen (Inst); LEO Pharma; Bristol-Myers Squibb; Acerta (Inst); Infinity (Inst); Onyx Pharmaceuticals (Inst); Janssen Oncology (Inst); Gilead Sciences (Inst); Spectrum Pharmaceuticals (Inst); Celgene (Inst); TG Therapeutics (Inst); Genentech/Roche (Inst); Pharmacyclics (Inst); Eisai Inc; Bayer (Inst); Boehringer Ingelheim (Inst); Eisai Inc; Baxter Biosciences (Inst)Resumen
Purpose
To provide current recommendations about the prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer.
Methods
PubMed and the Cochrane Library were searched for randomized controlled trials, systematic
reviews, meta-analyses, and clinical practice guidelines from November 2012 through July 2014.
An update committee reviewed the identified abstracts.
Results
Of the 53 publications identified and reviewed, none prompted a change in the
2013 recommendations.
Recommendations
Most hospitalized patients with active cancer require thromboprophylaxis throughout hospitalization. Routine thromboprophylaxis is not recommended for patients with cancer in the outpatient
setting. It may be considered for selected high-risk patients. Patients with multiple myeloma
receiving antiangiogenesis agents with chemotherapy and/or dexamethasone should receive
prophylaxis with either low–molecular weight heparin (LMWH) or low-dose aspirin. Patients
undergoing major surgery should receive prophylaxis starting before surgery and continuing for at
least 7 to 10 days. Extending prophylaxis up to 4 weeks should be considered in those undergoing
major abdominal or pelvic surgery with high-risk features. LMWH is recommended for the initial
5 to 10 days of treatment for deep vein thrombosis and pulmonary embolism as well as for
long-term secondary prophylaxis (at least 6 months). Use of novel oral anticoagulants is not
currently recommended for patients with malignancy and VTE because of limited data in patients
with cancer. Anticoagulation should not be used to extend survival of patients with cancer in the
absence of other indications. Patients with cancer should be periodically assessed for VTE risk.
Oncology professionals should educate patients about the signs and symptoms of VTE.