Use of low-molecular-weight heparins in cancer patients with renal impairment: a review

2012 ◽  
Vol 129 ◽  
pp. S184
Author(s):  
J-B. Rey ◽  
V. Launay-Vacher ◽  
F. Scotte
Keyword(s):  
Molecular Weight ◽  
Renal Impairment ◽  
Cancer Patients ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins

scholarly journals Tinzaparin Safety in Patients With Cancer and Renal Impairment: A Systematic Review

2021 ◽  
Vol 27 ◽  
pp. 107602962097959
Author(s):  
I. A. Vathiotis ◽  
N. K. Syrigos ◽  
E. P. Dimakakos
Keyword(s):  
Systematic Review ◽  
Molecular Weight ◽  
Renal Impairment ◽  
Creatinine Clearance ◽  
Cancer Patients ◽  
Major Bleeding ◽  
Severe Renal Impairment ◽  
Special Populations ◽  
Low Molecular Weight ◽  
Patients With Cancer

Low-molecular-weight heparins are approved for primary and secondary venous thromboembolism prevention. Tinzaparin is the low-molecular-weight heparin with the highest average molecular weight. The purpose of this systematic review is to provide an update regarding the safety profile of tinzaparin, prescribed either as a prophylactic or as a therapeutic regimen for venous thromboembolism in special populations, including cancer patients and patients with renal impairment. We identified prospective studies up to August 2020 reporting safety outcomes for cancer patients and patients with renal impairment on tinzaparin regimens. In patients with cancer major bleeding rates fluctuated between 0.8% and 7%. Patients on tinzaparin exhibited significantly lower rates of clinically relevant nonmajor bleeding events in comparison with those on vitamin K antagonists. Bioaccumulation of tinzaparin was not correlated with age, body weight or creatinine clearance. Periodic administration of either prophylactic or therapeutic doses of tinzaparin did not result in bioaccumulation, even in patients with severe renal impairment and creatinine clearance < 20 ml/min. Major bleeding rates for non-cancer patients with renal impairment on prophylactic tinzaparin regimens were 0%. Non-cancer patients with renal impairment on therapeutic tinzaparin regimens exhibited major bleeding in 0 to 3.4% of cases; major bleeding rates were higher for cancer patients with renal impairment on therapeutic tinzaparin regimens (4.3 to 10%). Tinzaparin can be used without dose adjustment in patients with severe renal impairment and creatinine clearance > 20 ml/min. Tinzaparin represents a safe choice for special populations at increased risk for thrombosis and bleeding.

scholarly journals Specifics of the perioperative management of the patients undergoing surgery for malignant neoplasms during the COVID-19 pandemic

2020 ◽  
Vol 48 ◽  
pp. 68-72
Author(s):  
A. S. Allakhverdyan ◽  
A. N. Anipchenko ◽  
N. N. Anipchenko
Keyword(s):  
Molecular Weight ◽  
Surgical Treatment ◽  
Cancer Patients ◽  
Malignant Tumors ◽  
Malignant Neoplasms ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Strict Adherence ◽  
Malignant Skin Tumors ◽  
Coronavirus Infection

Background: The worse prognosis in cancer patients with COVID-19 infection in the context of the pandemic, compared to that in the general population, poses new challenges to ensure the perioperative safety.Aim: To reduce the risk of infection for cancer patients in the perioperative period and to prevent severe COVID-19.Materials and methods: During two months of the COVID-19 (from March to April 2020), we performed 158 surgical interventions: 49 for breast cancer, 31 for lung cancer (videothoracoscopic segmental and lobar resections), 12 for stomach cancer (8 distal and 1 proximal laparoscopic subtotal gastric resections, 3 gastrectomies), 16 laparoscopic resections for colorectal cancer, 29 resections with a reconstructive plastic for malignant skin tumors, 21 palliative and diagnostic operations (diagnostic thoracoscopy and laparoscopy, laparoscopic colostomy).Results: Preventive administration during preparation for surgery (interferon-al-pha2b and low molecular weight heparins) and for suspected infection (antibiotics, low molecular weight heparins and dexamethasone 12 mg/day intravenously) allowed for lower rates of the new coronavirus infection (1.3%) and its severe cases (0%) during surgical treatment of malignant tumors.Conclusion: Surgical treatment of cancer patients in the context of a new coronavirus infection pandemic should be carried out with strict adherence to anti-epidemic measures.

scholarly journals Prevention and treatment of thrombosis in cancer and oncohematological patients

2021 ◽  
Vol 16 (4) ◽  
pp. 40-49
Author(s):  
O. V. Somonova ◽  
A. L. Elizarova ◽  
T. V. Davydova
Keyword(s):  
Molecular Weight ◽  
Cancer Patients ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Oncological Patient ◽  
Risk Of Death ◽  
Prevention And Treatment ◽  
Thrombotic Complications

The purpose of the review is to highlight the current possibilities for the prevention and treatment of venous thrombotic complications in patients with cancer.The data of 52 scientific sources published in the Russian and foreign press in 1997–2020 are considered.Cancer patients are at high risk of thrombotic complications, which worsen the outcome of anticancer treatment and are one of the leading causes of death. Thrombosis in an oncological patient increases the risk of death by 30 times, which is associated with fatal thromboembolism and a more aggressive course of the disease. The leading role in the pathogenesis of thrombotic complications is played by disorders in the hemostasis system caused both by the tumor itself and by therapy. Low molecular weight heparins are considered the basis for specific prophylaxis of thromboembolic complications in cancer patients. The use of low molecular weight heparins after surgery and during chemotherapy effectively reduces the incidence of venous thrombosis. Direct oral anticoagulants are promising drugs for oral administration and are indicated as one of the treatment options for patients with tumor-associated thrombosis with a low risk of bleeding and no drug interactions with ongoing systemic chemotherapy.

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