ABSTRACT
BACKGROUND: Venous thromboembolism (VTE) and major bleeding (MB) are common in cancer patients. Reduced-doses of antithrombotics as secondary prophylaxis have limited data. This work aims to describe and to compare treatments and outcomes for cancer-associated VTE. RESEARCH DESIGN AND METHODS: Retrospective study. Adults with cancer-associated VTE were included. After 3-6 months of full-doses of anticoagulants, three strategies were considered: A) lowering the doses; B) maintaining full-doses; C) stopping treatment. The strategy and medication used were shown in a descriptive analysis and the rate of bleeding and VTE-recurrence between those in a comparative analysis. RESULTS: A total of 420 patients were included, 56.2% received DOACs, 43.8% enoxaparin. Strategy was defined in 257 patients: A (50.2%), B (46.3%), and C (3.5%). Forty-one (9.8%) had VTE-recurrence and 15 (3.6%) had MB or clinically relevant non-major bleeding (CRNMB).According to strategy, recurrent-VTE was 8.5% (A), 4.2% (B), and 11.1 (C) (p = 0.22), MB or CRNMB was 0.8% (A), 1.7% (B), and 0% (C) (p = 0.64). CONCLUSIONS: DOACs and strategy A were the most frequently used agent and strategy, respectively. There were no differences between medications or strategies used. The results must be interpreted with caution, and it is a retrospective single-center study, probably with information and selection bias.
Subject(s)
Neoplasms , Venous Thromboembolism , Adult , Humans , Heparin, Low-Molecular-Weight/adverse effects , Venous Thromboembolism/etiology , Venous Thromboembolism/complications , Retrospective Studies , Argentina/epidemiology , Anticoagulants/adverse effects , Hemorrhage/etiology , Neoplasms/complications , Neoplasms/drug therapyABSTRACT
El síndrome antifosfolipídico fue descripto por Hughes y col. en 1983. Tiene múltiples manifestaciones clínicas en donde las vasculares y hemostáticas son las más prevalentes. Describimos cuatro casos que ilustran los problemas más comunes de la práctica clínica. El síndrome de Hughes ha extendido el uso del tratamiento antitrombótico al campo de la obstetricia donde la trombofilia es responsable de eventos serios como los abortos recurrentes. Esto es lo que justificó en nuestro hospital el funcionamiento de un consultorio de Hematología del Embarazo
Subject(s)
Adolescent , Adult , Aged , Antiphospholipid Syndrome/classification , Antiphospholipid Syndrome/diagnosis , Lupus Coagulation Inhibitor , Thrombophilia/complications , Thrombophilia/diagnosis , Abortion, Habitual/diagnosisABSTRACT
El síndrome antifosfolipídico fue descripto por Hughes y col. en 1983. Tiene múltiples manifestaciones clínicas en donde las vasculares y hemostáticas son las más prevalentes. Describimos cuatro casos que ilustran los problemas más comunes de la práctica clínica. El síndrome de Hughes ha extendido el uso del tratamiento antitrombótico al campo de la obstetricia donde la trombofilia es responsable de eventos serios como los abortos recurrentes. Esto es lo que justificó en nuestro hospital el funcionamiento de un consultorio de Hematología del Embarazo
