Blood Advances· 2021Q1· Guideline
American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer
- 854citations
- Q1SCImago
- 2021year
Short summary
New American Society of Hematology (ASH) guidelines recommend against thromboprophylaxis for low-risk ambulatory cancer patients receiving chemotherapy, but strongly advise low-molecular-weight heparin (LMWH) for initial VTE treatment in cancer patients.
AI-generated from the title and abstract; the full text is not read.
Key points
- Strong recommendation: Do not use thromboprophylaxis in ambulatory cancer patients at low risk of VTE.
- Strong recommendation: Use low-molecular-weight heparin (LMWH) for initial treatment of VTE in patients with cancer.
- Conditional recommendation: Use thromboprophylaxis in hospitalized medical patients with cancer.
- Conditional recommendations for LMWH or DOACs for initial, short-term, and long-term VTE treatment in various ambulatory cancer patient subgroups.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND: Venous thromboembolism (VTE) is a common complication among patients with cancer. Patients with cancer and VTE are at a markedly increased risk for morbidity and mortality. OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about the prevention and treatment of VTE in patients with cancer. METHODS: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The guideline development process was supported by updated or new systematic evidence reviews. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess evidence and make recommendations. RESULTS: Recommendations address mechanical and pharmacological prophylaxis in hospitalized medical patients with cancer, those undergoing a surgical procedure, and ambulatory patients receiving cancer chemotherapy. The recommendations also address the use of anticoagulation for the initial, short-term, and long-term treatment of VTE in patients with cancer. CONCLUSIONS: Strong recommendations include not using thromboprophylaxis in ambulatory patients receiving cancer chemotherapy at low risk of VTE and to use low-molecular-weight heparin (LMWH) for initial treatment of VTE in patients with cancer. Conditional recommendations include using thromboprophylaxis in hospitalized medical patients with cancer, LMWH or fondaparinux for surgical patients with cancer, LMWH or direct oral anticoagulants (DOAC) in ambulatory patients with cancer receiving systemic therapy at high risk of VTE and LMWH or DOAC for initial treatment of VTE, DOAC for the short-term treatment of VTE, and LMWH or DOAC for the long-term treatment of VTE in patients with cancer.
The authors' abstract, as published at the source. Blood Advances, 2021 · DOI ↗
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Field: Internal Medicine
Internal MedicineMedicine