Epidemiology, biology, and management of venous thromboembolism in gliomas: An interdisciplinary review.
deep venous thrombosis
glioblastoma
glioma
podoplanin
pulmonary embolism
tissue factor
venous thromboembolism
Journal
Neuro-oncology
ISSN: 1523-5866
Titre abrégé: Neuro Oncol
Pays: England
ID NLM: 100887420
Informations de publication
Date de publication:
03 08 2023
03 08 2023
Historique:
pmc-release:
26
04
2024
medline:
4
8
2023
pubmed:
27
4
2023
entrez:
26
4
2023
Statut:
ppublish
Résumé
Patients with diffuse glioma are at high risk of developing venous thromboembolism (VTE) over the course of the disease, with up to 30% incidence in patients with glioblastoma (GBM) and a lower but nonnegligible risk in lower-grade gliomas. Recent and ongoing efforts to identify clinical and laboratory biomarkers of patients at increased risk offer promise, but to date, there is no proven role for prophylaxis outside of the perioperative period. Emerging data suggest a higher risk of VTE in patients with isocitrate dehydrogenase (IDH) wild-type glioma and the potential mechanistic role of IDH mutation in the suppression of production of the procoagulants tissue factor and podoplanin. According to published guidelines, therapeutic anticoagulation with low molecular weight heparin (LMWH) or alternatively, direct oral anticoagulants (DOACs) in patients without increased risk of gastrointestinal or genitourinary bleeding is recommended for VTE treatment. Due to the elevated risk of intracranial hemorrhage (ICH) in GBM, anticoagulation treatment remains challenging and at times fraught. There are conflicting data on the risk of ICH with LMWH in patients with glioma; small retrospective studies suggest DOACs may convey lower ICH risk than LMWH. Investigational anticoagulants that prevent thrombosis without impairing hemostasis, such as factor XI inhibitors, may carry a better therapeutic index and are expected to enter clinical trials for cancer-associated thrombosis.
Identifiants
pubmed: 37100086
pii: 7143628
doi: 10.1093/neuonc/noad059
pmc: PMC10398809
doi:
Substances chimiques
Heparin, Low-Molecular-Weight
0
Anticoagulants
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1381-1394Subventions
Organisme : NHLBI NIH HHS
ID : R35 HL155657
Pays : United States
Organisme : NCI NIH HHS
ID : P50 CA221747
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS117104
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS102669
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS118039
Pays : United States
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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