Journal of Clinical Oncology· 2015Q1· Clinical trial
Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update 2014
- 1,374citations
- Q1SCImago
- 2015year
Short summary
The 2014 ASCO guideline update confirms existing recommendations for venous thromboembolism (VTE) prophylaxis and treatment in cancer patients, finding no new evidence to warrant changes from the 2013 guidelines.
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Key points
- Most hospitalized cancer patients require thromboprophylaxis during hospitalization.
- Routine thromboprophylaxis is not recommended for outpatient cancer patients, but may be considered for selected high-risk individuals.
- Patients with multiple myeloma on specific treatments should receive prophylaxis with LMWH or aspirin.
- Low-molecular-weight heparin (LMWH) is recommended for initial VTE treatment and long-term secondary prophylaxis (at least 6 months).
- Novel oral anticoagulants are not currently recommended for VTE in cancer patients due to limited data.
AI-generated from the title and abstract; the full text is not read.
Abstract
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.
The authors' abstract, as published at the source. Journal of Clinical Oncology, 2015 · DOI ↗
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Field: Internal Medicine
Internal MedicineMedicine