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Safety of anticoagulant treatment in cancer patients |
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| Authors: | Ineke Theodora Wilts Suzanne Mariëlla Bleker Nick Van Es Harry Roger Büller Marcello Di Nisio Pieter Willem Kamphuisen |
| Institution: | 1. University Medical Center Groningen, Department of Vascular Medicine, Hanzeplein 1, 9700 GZ Groningen, The Netherlands +31 50 36 12943;2. +31 50 36 19069;3. i.t.wilts@umcg.nl;4. Academic Medical Center, Department of Vascular Medicine, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands;5. G.D’Annunzio University, Department of Medical, Oral and Biotechnological Sciences, Via dei Vestini 31, 66013 Chieti, Italy |
| Abstract: | Introduction: Patients with cancer are at increased risk of (recurrent) venous thromboembolism. They are also at increased risk of bleeding. This makes treatment of venous thromboembolisms (VTE) in cancer patients challenging. Areas covered: In this review, we will focus on the safety of anticoagulant treatment of VTE in cancer patients. We will discuss the absolute and relative bleeding risks associated with the various types of anticoagulants, specifically focusing on low-molecular-weight heparins (LMWH), vitamin K antagonist (VKA) and the new oral anticoagulants (NOACs). Expert opinion: Monotherapy with LMWH is recommended for treatment of acute VTE in cancer patients. The bleeding risk associated with LMWH is comparable to VKAs, but LMWH are more effective in preventing recurrent VTE. More evidence on the efficacy and safety of NOACs in cancer patients is needed. |
| Keywords: | anticoagulant treatment bleeding cancer low-molecular-weight heparins new oral anticoagulants venous thromboembolism vitamin k antagonists |