scholarly journals Risk assessment for recurrent venous thromboembolism in patients with cancer

2021 ◽  
pp. 100080
Author(s):  
Cornelia Englisch ◽  
Florian Moik ◽  
Cihan Ay
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Patients With Cancer ◽  
Recurrent Venous Thromboembolism

Recurrent thrombosis followed by Lazarus response in ROS1 rearranged NSCLC treated with crizotinib: a case report

2020 ◽  
Vol 106 (6) ◽  
pp. NP41-NP45
Author(s):  
Teresa Beninato ◽  
Giuseppe Lo Russo ◽  
Marina Chiara Garassino ◽  
Filippo De Braud ◽  
Marco Platania
Keyword(s):  
Venous Thromboembolism ◽  
Genetic Alterations ◽  
Small Cell Lung ◽  
Recurrent Thrombosis ◽  
Right Heart ◽  
Thromboembolic Risk ◽  
Patients With Cancer ◽  
Recurrent Venous Thromboembolism ◽  
Progressive Respiratory Failure ◽  
Alk Positive

Introduction: Patients with cancer have higher risk of thrombosis compared to the general population and particularly lung adenocarcinoma is considered at high risk for venous thromboembolism. Some targetable oncogenic drivers are supposed to further increase this risk. Case description: A 35-year-old man who had developed a recurrent venous thromboembolism and pulmonary embolism (PE) was diagnosed with ROS1 rearranged non-small cell lung cancer (NSCLC). While molecular examinations were ongoing, he developed progressive respiratory failure. For PE and thrombosis worsening with detection of right heart thrombus, he underwent therapy with unfractionated heparin. Despite initial good radiologic results, only with the start of crizotinib did the patient’s clinical condition significantly improve to configure a Lazarus response. Conclusions: Cancer diagnosis should always be considered in patients with unprovoked thrombosis and, if NSCLC is diagnosed, genetic alterations should be always sought after. A possible relation between venous thromboembolism and oncogenic drivers, particularly for ALK translocations, has been hypothesized. Similarly to ALK-positive NSCLC, ROS1 rearranged disease has been associated with an increased thromboembolic risk. Further studies are needed to better evaluate this relation and to evaluate the potential benefit of a prophylactic anticoagulating treatment in this subset of patients.

Tissue Factor As a Predictor of Recurrent Venous Thromboembolism in Malignancy: Biomarker Analyses of the CATCH Trial

2017 ◽  
Vol 35 (10) ◽  
pp. 1078-1085 ◽  
Author(s):  
Alok A. Khorana ◽  
Pieter W. Kamphuisen ◽  
Guy Meyer ◽  
Rupert Bauersachs ◽  
Mette S. Janas ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Venous Thromboembolism ◽  
Tissue Factor ◽  
Competing Risk ◽  
Subdistribution Hazard ◽  
Patients With Cancer ◽  
Potential Biomarker ◽  
Recurrent Venous Thromboembolism ◽  
Multiple Variables ◽  
Recurrent Vte

Purpose Circulating tissue factor (TF) has been studied as a biomarker for predicting initial, but not recurrent, venous thromboembolism (VTE) in cancer, a setting in which predictors are incompletely understood. We evaluated the association of TF, clinical risk factors, and other biomarkers measured at the time of initial VTE with recurrent VTE in a prespecified analysis of the CATCH (Comparison of Acute Treatments in Cancer Hemostasis) trial. Methods CATCH was a randomized, multicenter trial that investigated tinzaparin 175 IU/kg once daily or dose-adjusted warfarin for 6 months in patients with cancer and acute, symptomatic VTE. TF ELISA, soluble P-selectin, d-dimer, FVIII, and C-reactive protein were assayed. Fisher’s exact test was used to screen for association with VTE; competing risk regression analysis of time to recurrent VTE was conducted, accounting for multiple variables. Results The study population comprised 900 patients (recurrent VTE, n = 76; 8.4%). Of these patients, 805 had samples available for TF assay. Mean and median TF levels were 72.5 pg/mL and 50.3 pg/mL, respectively (range, 15.6 pg/mL to 4,798 pg/mL). Patients in the highest quartile of TF experienced the greatest VTE recurrence (> 64.6 pg/mL; 38 [19%] of 203 patients v 34 [6%] of 602 patients; relative risk, 3.3; 95% CI, 2.1 to 5.1; P < .001). In competing risk regression analysis of time to recurrent VTE, TF remained strongly associated with recurrent VTE (subdistribution hazard ratio [SHR], 3.3; 95% CI, 1.7 to 6.4). Other significant variables included venous compression from mass (SHR, 3.1; 95% CI, 1.4 to 6.5) and hepatobiliary cancer (SHR, 5.5; 95% CI, 2.3 to 13.6). Conclusion This is the first report, to our knowledge, to describe TF as a potential biomarker of recurrent VTE in patients with cancer who are on anticoagulation treatment. A risk-adapted strategy could help identify high-risk patients who may benefit from more intensive anticoagulation approaches.

Predicting the risk of recurrent venous thromboembolism in patients with cancer: A prospective cohort study

2018 ◽  
Vol 163 ◽  
pp. 41-46 ◽  
Author(s):  
Nick van Es ◽  
Martha Louzada ◽  
Marc Carrier ◽  
Vicky Tagalakis ◽  
Peter L. Gross ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Patients With Cancer ◽  
Recurrent Venous Thromboembolism

Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis

Blood ◽  
2002 ◽  
Vol 100 (10) ◽  
pp. 3484-3488 ◽  
Author(s):  
Paolo Prandoni ◽  
Anthonie W. A. Lensing ◽  
Andrea Piccioli ◽  
Enrico Bernardi ◽  
Paolo Simioni ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Major Bleeding ◽  
Cumulative Incidence ◽  
Hazard Ratio ◽  
Anticoagulant Treatment ◽  
Thromboembolic Complications ◽  
Patients With Cancer ◽  
Recurrent Venous Thromboembolism

A small proportion of patients with deep vein thrombosis develop recurrent venous thromboembolic complications or bleeding during anticoagulant treatment. These complications may occur more frequently if these patients have concomitant cancer. This prospective follow-up study sought to determine whether in thrombosis patients those with cancer have a higher risk for recurrent venous thromboembolism or bleeding during anticoagulant treatment than those without cancer. Of the 842 included patients, 181 had known cancer at entry. The 12-month cumulative incidence of recurrent thromboembolism in cancer patients was 20.7% (95% CI, 15.6%-25.8%) versus 6.8% (95% CI, 3.9%- 9.7%) in patients without cancer, for a hazard ratio of 3.2 (95% CI, 1.9-5.4) The 12-month cumulative incidence of major bleeding was 12.4% (95% CI, 6.5%-18.2%) in patients with cancer and 4.9% (95% CI, 2.5%-7.4%) in patients without cancer, for a hazard ratio of 2.2 (95% CI, 1.2-4.1). Recurrence and bleeding were both related to cancer severity and occurred predominantly during the first month of anticoagulant therapy but could not be explained by sub- or overanticoagulation. Cancer patients with venous thrombosis are more likely to develop recurrent thromboembolic complications and major bleeding during anticoagulant treatment than those without malignancy. These risks correlate with the extent of cancer. Possibilities for improvement using the current paradigms of anticoagulation seem limited and new treatment strategies should be developed.

Sign in / Sign up

Export Citation Format

Share Document