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Current Oncology Reports

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01-02-2019 | Nausea | Palliative Medicine (A Jatoi, Section Editor)

Anticoagulation in Cancer Patients: a Summary of Pitfalls to Avoid

Authors: Harsh K. Patel, Alok A. Khorana

Published in: Current Oncology Reports | Issue 2/2019

Abstract

Purpose of Review

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in cancer patients, and its management is often associated with complications including risk of recurrent VTE and bleeding. Here, we review the current data on pitfalls during anticoagulation in cancer patients and measures necessary to avoid them.

Recent Findings

Although low-molecular-weight heparin monotherapy has been the standard of treatment for several years, emerging data for direct oral anticoagulants (DOACs) are leading to new paradigms in treatment. Reports of recent randomized trials suggest a lower risk of recurrent thrombosis but higher risk of bleeding, particularly in gastrointestinal cancer patients, with DOACs. Careful patient selection and individualization of therapy based on risk of bleeding as well as recurrent VTE are keys.

Summary

Problems like bleeding, recurrence, thrombocytopenia, drug-drug interactions, renal impairment, nausea-vomiting along with concerns about adherence arise during anticoagulation in cancer patients. However, with adequate pre-treatment assessment, correct anticoagulant selection and proper monitoring during anticoagulation, these issues can be addressed safely and effectively.

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Title: Anticoagulation in Cancer Patients: a Summary of Pitfalls to Avoid
Authors: Harsh K. Patel
Alok A. Khorana
Publication date: 01-02-2019
Publisher: Springer US
Keywords: Nausea
Anticoagulant
Direct Oral Anticoagulant
Vomiting
Thrombocytopenia
Warfarin
Direct Oral Anticoagulant
Cytostatic Therapy
Published in: Current Oncology Reports / Issue 2/2019
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI: https://doi.org/10.1007/s11912-019-0767-5

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