Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update 2014
Lyman GH, Bohlke K, Khorana AA, Kuderer NM, Lee AY, Arcelus JI, Balaban EP, Clarke JM, Flowers CR, Francis CW, Gates LE, Kakkar AK, Key NS, Levine MN, Liebman HA, Tempero MA, Wong SL, Somerfield MR, Falanga A; American Society of Clinical Oncology
J Clin Oncol. 2015 Feb 20;33(6):654-6
CARDIONCOLOGY.ORG ABSTRACT:
This article provides current recommendations about the prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer. Specifically, most hospitalized patients with active cancer require thromboprophylaxis throughout hospitalization.
Patients with multiple myeloma receiving antiangiogenesis agents with chemotherapy and/or dexamethasone should receive prophylaxis with either low-molecular weight heparin (LMWH) or low-dose aspirin.
Surgical patients should also receive prophylaxis before surgery and continuing for at least 7 to 10 days. In contrast, routine thromboprophylaxis is not recommended for patients with cancer in the outpatient setting unless patient is considered high-risk.
LMWH is recommended for the initial 5 to 10 days of treatment for deep vein thrombosis and pulmonary embolism as well as for long-term secondary prophylaxis (at least 6 months).
Finally, use of novel oral anticoagulants is not currently recommended for patients with malignancy and VTE because of limited data in patients with cancer.
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