الفهرس | Only 14 pages are availabe for public view |
Abstract VTE is a common complication of cancer and is occurring in up to 20% of cancer patients with reduced survival rate. In patients with cancer, the risk of first-time VTE is highly variable and depends primarily on the tumor type, metastatic stage at the time of diagnosis, presence of concurrent chronic medical conditions, indwelling catheters and clinical characteristics including hemoglobin, platelet count and tissue factor, and use of specific chemotherapeutic and erythropoiesis-stimulating agents.Malignant cells can activate blood coagulation in several ways: by producing procoagulant molecules (TF and CP) and fibrinolytic activities; by releasing proinflammatory and proangiogenic cytokines; and by interacting directly with host vascular and blood cells, such as endothelial cells and platelets.LMWHs are the therapy of choice for patients with cancer-associated thrombosis. With acute leukemia prophylactic platelet transfusion therapy is universally applied in the supportive care of these patients. In case of absolute contraindications to anticoagulant therapy these patients can use IVC filters. The risk of concomitant cancer is increased in patients with idiopathic VTE compared with secondary VTE, so extensive screening for cancer in these patients is able to not only detect the majority of malignancies but also to the identification of malignancies at an earlier stage for earlier treatment. |