[Cancer-associated coagulation disorders].
Gerinnungsstörungen bei Tumorerkrankungen.
Anticoagulants
Disseminated intravascular coagulation
Hemophilia A, acquired
Venous thromboembolism
Von Willebrand disease, acquired
Journal
Dermatologie (Heidelberg, Germany)
ISSN: 2731-7013
Titre abrégé: Dermatologie (Heidelb)
Pays: Germany
ID NLM: 9918384885206676
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
pubmed:
15
9
2022
medline:
28
9
2022
entrez:
14
9
2022
Statut:
ppublish
Résumé
Diagnosis and treatment of paraneoplastic coagulation disorders are a challenge in daily practice. While prophylactic anticoagulation to prevent venous thromboembolism (VTE) is standard of care in all surgical and acutely ill medical cancer patients, particularly careful evaluation of risks and benefits using validated risk assessment models is required during outpatient chemotherapy. Low-molecular-weight heparin and direct oral factor Xa inhibitors are available to treat established cancer-associated VTE, adhering to algorithms for bleeding risk stratification. In patients with overt disseminated intravascular coagulation, therapeutic measures should strictly follow clinical symptoms. An acquired von Willebrand syndrome may evoke a severe bleeding tendency in patients with myeloproliferative neoplasms or plasma cell dyscrasias. In 15% of cases, acquired hemophilia A, due to the formation of inhibitory autoantibodies against coagulation factor VIII, is associated with malignancy. Diagnostik und Therapie paraneoplastischer Gerinnungsstörungen stellen im Praxisalltag eine große Herausforderung dar. Während die prophylaktische Antikoagulation zur Vorbeugung einer venösen Thromboembolie (VTE) bei chirurgischen und akut erkrankten internistischen Tumorpatienten etablierter Standard ist, muss unter ambulanter Systemtherapie eine besonders sorgfältige Abwägung auf Basis validierter Risikomodelle erfolgen. Die Differenzialtherapie der krebsassoziierten VTE umfasst niedermolekulare Heparine und direkte orale Faktor-Xa-Inhibitoren. Bei disseminierter intravasaler Gerinnung richten sich die therapeutischen Maßnahmen strikt nach der klinischen Symptomatik. Das erworbene Von-Willebrand-Syndrom kann bei Patienten mit myeloproliferativen Neoplasien oder Plasmazellerkrankungen eine schwere Blutungsneigung hervorrufen. In 15 % der Fälle ist die erworbene Hämophilie A, verursacht durch inhibitorische Autoantikörper gegen Faktor VIII, mit einem Malignom assoziiert.
Autres résumés
Type: Publisher
(ger)
Diagnostik und Therapie paraneoplastischer Gerinnungsstörungen stellen im Praxisalltag eine große Herausforderung dar. Während die prophylaktische Antikoagulation zur Vorbeugung einer venösen Thromboembolie (VTE) bei chirurgischen und akut erkrankten internistischen Tumorpatienten etablierter Standard ist, muss unter ambulanter Systemtherapie eine besonders sorgfältige Abwägung auf Basis validierter Risikomodelle erfolgen. Die Differenzialtherapie der krebsassoziierten VTE umfasst niedermolekulare Heparine und direkte orale Faktor-Xa-Inhibitoren. Bei disseminierter intravasaler Gerinnung richten sich die therapeutischen Maßnahmen strikt nach der klinischen Symptomatik. Das erworbene Von-Willebrand-Syndrom kann bei Patienten mit myeloproliferativen Neoplasien oder Plasmazellerkrankungen eine schwere Blutungsneigung hervorrufen. In 15 % der Fälle ist die erworbene Hämophilie A, verursacht durch inhibitorische Autoantikörper gegen Faktor VIII, mit einem Malignom assoziiert.
Identifiants
pubmed: 36102956
doi: 10.1007/s00105-022-05056-8
pii: 10.1007/s00105-022-05056-8
doi:
Substances chimiques
Autoantibodies
0
Factor Xa Inhibitors
0
Heparin, Low-Molecular-Weight
0
Factor VIII
9001-27-8
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
809-819Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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