Venous thromboembolism in cancer patients

Year 2013, Volume: 35 Issue: 3, 442 - 447, 27.09.2013

Mehmet Eren Birsen Yücel Saadettin Kılıçkap

Abstract

Abstract

Venous thromboembolism (VTE) is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8%in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT) and pulmonary embolism (PE) is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH) or low molecular weight heparin (LMWH). Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.

Keywords: Venous thromboembolism, cancer, anticoagulation, chemotherapy, low molecular weight heparin

 

Özet

Venöz tromboembolizm (VTE) kanser hastalığının major komplikasyonu, morbidite ve mortalitenin en önemli nedenidir. Kanser hastalarında VTE insidansı %0,6-7,8 olup, kanser olmayan hastalardaki VTE insidansından 2 kat daha fazladır. Kanser hastalarında VTE görülme riski, buna derin ven trombozu ve pulmoner embolism de eklendiğinde 2-7 kat arası artmaktadır. VTE riski özellikle hastanede yatan kanser hastalarında ve antineoplastik tedavi alanlarda yüksektir. Bununla beraber büyük cerrahi operasyon geçiren hastalarda da VTE riski artmaktadır. Travma, uzun sureli yolculuk, ileri yaş, obezite, önceden geçirilmiş VTE ve genetik gibi faktörler VTE için predispozan faktörlerdendir. Kanser hastalarındaki tromboproflaksideki primer amaç VTE gelişmesini önlemektir. Kanser hastalarının büyük bir çoğunluğu fraksiyone olmayan heparin ve düşük molekül ağırlıklı heparin ile tedavi edilmelidir. Büyük cerrahi operasyon geçiren kanser hastalarında proflaksi yapılmalıdır.

Anahtar sözcükler: Venöz tromboembolizm, kanser, antikoagulasyon, kemoterapi, düşük molekül ağırlıklı heparin

Keywords

Venous thromboembolism, cancer, anticoagulation, chemotherapy, low molecular weight heparin

Kanser hastalarında venöz tromboembolizm

Abstract

Venöz tromboembolizm (VTE) kanser hastalığının major komplikasyonu, morbidite ve mortalitenin en önemli nedenidir. Kanser hastalarında VTE insidansı %0,6-7,8 olup, kanser olmayan hastalardaki VTE insidansından 2 kat daha fazladır. Kanser hastalarında VTE görülme riski, buna derin ven trombozu ve pulmoner embolism de eklendiğinde 2-7 kat arası artmaktadır. VTE riski özellikle hastanede yatan kanser hastalarında ve antineoplastik tedavi alanlarda yüksektir. Bununla beraber büyük cerrahi operasyon geçiren hastalarda da VTE riski artmaktadır. Travma, uzun sureli yolculuk, ileri yaş, obezite, önceden geçirilmiş VTE ve genetik gibi faktörler VTE için predispozan faktörlerdendir. Kanser hastalarındaki tromboproflaksideki primer amaç VTE gelişmesini önlemektir. Kanser hastalarının büyük bir çoğunluğu fraksiyone olmayan heparin ve düşük molekül ağırlıklı heparin ile tedavi edilmelidir. Büyük cerrahi operasyon geçiren kanser hastalarında proflaksi yapılmalıdır.

Keywords

Venöz tromboembolizm, kanser, antikoagulasyon, kemoterapi, düşük molekül ağırlıklı heparin

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