The American Society of Clinical Oncology (ASCO) has released recommended guidelines for the prevention of venous thromboembolism (VTE) in patients with cancer. These results were published in the December 1, 2007 issue of the Journal of Clinical Oncology.

Patients with malignancies have an increased risk of developing VTE. However, risk factors that may convey a higher risk of developing venous thrombosis are not yet clear. Once patients can be classified as high-risk versus low-risk for developing thrombosis through risk assessment models, possible prevention guidelines may be established in order to reduce the incidence of thrombosis and its sequelae in cancer patients. Recently, researchers from the Netherlands reported that patients with hematologic, lung and gastrointestinal cancers, are at a significantly increased risk of developing VTE. Prevention of VTE is also an important economic issue. Researchers from MD Anderson Cancer have reported that deep venous thromboses in cancer patients results in a mean hospitalization time of 11 days and costs over $20,000. 

Physicians affiliated with ASCO recently reviewed data from medical literature regarding prevention and treatment of VTE in cancer patients. This review included trials that evaluated prevention and treatment of VTE and the impact of anticoagulation agents on survival. Based on these evaluations, the following recommendations were made:

• All hospitalized cancer patients should be considered for VTE prophylaxis with anticoagulants in the absence of bleeding or other contraindications.
• Routine prophylaxis of ambulatory cancer patients with anticoagulation is not recommended, with the exception of patients receiving thalidomide or lenalidomide.
• Patients undergoing major surgery for malignant disease should be considered for pharmacologic thromboprophylaxis.
• Low molecular weight heparin represents the preferred agent for both the initial and continuing treatment of cancer patients with established VTE.
• The impact of anticoagulants on cancer patient survival requires additional study and cannot be recommended at present.

Comments: These guidelines should provide useful information that should lower the incidence of VTE in cancer patients.

Related News:

Risk of Venous Thrombosis Increased in Patients with Malignancies (02/16/2005)

Prophylactic Low Molecular Weight Heparin May Decrease Thalidomide-Induced Deep Vein Thrombosis (08/31/2004)  

 Deep Venous Thrombosis in Cancer Patients is a Costly Complication (08/30/2004)

Reference: Lyman G, Khorana A, Falanga A. American Society of Clinical Oncology Guideline: Recommendations for Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer. Journal of Clinical Oncology. 2007; 25:5490-5505.