EHA Guidelines on Management of Antithrombotic Treatments in Thrombocytopenic Patients With Cancer.


Journal

HemaSphere
ISSN: 2572-9241
Titre abrégé: Hemasphere
Pays: United States
ID NLM: 101740619

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 01 04 2022
accepted: 01 06 2022
entrez: 4 8 2022
pubmed: 5 8 2022
medline: 5 8 2022
Statut: epublish

Résumé

In cancer patients, thrombocytopenia can result from bone marrow infiltration or from anticancer medications and represents an important limitation for the use of antithrombotic treatments, including anticoagulant, antiplatelet, and fibrinolytic agents. These drugs are often required for prevention or treatment of cancer-associated thrombosis or for cardioembolic prevention in atrial fibrillation in an increasingly older cancer population. Data indicate that cancer remains an independent risk factor for thrombosis even in case of thrombocytopenia, since mild-to-moderate thrombocytopenia does not protect against arterial or venous thrombosis. In addition, cancer patients are at increased risk of antithrombotic drug-associated bleeding, further complicated by thrombocytopenia and acquired hemostatic defects. Furthermore, some anticancer treatments are associated with increased thrombotic risk and may generate interactions affecting the effectiveness or safety of antithrombotic drugs. In this complex scenario, the European Hematology Association in collaboration with the European Society of Cardiology has produced this scientific document to provide a clinical practice guideline to help clinicians in the management of patients with cancer and thrombocytopenia. The Guidelines focus on adult patients with active cancer and a clear indication for anticoagulation, single or dual antiplatelet therapy, their combination, or reperfusion therapy, who have concurrent thrombocytopenia because of either malignancy or anticancer medications. The level of evidence and the strength of the recommendations were discussed according to a Delphi procedure and graded according to the Oxford Centre for Evidence-Based Medicine.

Identifiants

pubmed: 35924068
doi: 10.1097/HS9.0000000000000750
pmc: PMC9281983
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e750

Informations de copyright

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.

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Auteurs

Anna Falanga (A)

University of Milano Bicocca, School of Medicine, Monza, Italy.
Department of Transfusion Medicine and Hematology, Hospital Papa Giovanni XXIII, Bergamo, Italy.

Avi Leader (A)

Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Chiara Ambaglio (C)

Department of Transfusion Medicine and Hematology, Hospital Papa Giovanni XXIII, Bergamo, Italy.

Zsuzsa Bagoly (Z)

Faculty of Medicine, Department of Laboratory Medicine, Division of Clinical Laboratory Sciences, University of Debrecen, Hungary.
ELKH-DE Cerebrovascular and Neurodegenerative Research Group, Debrecen, Hungary.

Giancarlo Castaman (G)

Center for Bleeding Disorders and Coagulation, Careggi University Hospital, Florence, Italy.

Ismail Elalamy (I)

Hematology and Thrombosis Center, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine, Sorbonne Université, Paris, France.
Research Group "Cancer, Haemostasis and Angiogenesis," INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France.

Ramon Lecumberri (R)

Hematology Service, Clínica Universidad de Navarra, Pamplona, Spain.
CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.

Alexander Niessner (A)

Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria.

Ingrid Pabinger (I)

Department of Medicine I, Clinical Division of Hematology and Hemostaseology, Medical University of Vienna, Austria.

Sebastian Szmit (S)

Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, Otwock, Poland.
Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

Alice Trinchero (A)

Department of Medical Oncology and Haematology Clinic, University Hospital Zurich, Switzerland.

Hugo Ten Cate (H)

Department of Internal Medicine, Thrombosis Expertise Center, Maastricht University Medical Center and CARIM School for Cardiovascular Diseases, Maastricht, the Netherlands.
Center for Thrombosis and Haemostasis, Gutenberg University Medical Center, Mainz, Germany.

Bianca Rocca (B)

Department of Safety and Bioethics, Section of Pharmacology, Catholic University School of Medicine, Rome, Italy.

Classifications MeSH