Thrombo-embolic events in cancer patients with impaired renal function

BJMO - volume 9, issue 2, may 2015

I. Elalamy MD, PhD, J-L. Canon MD, PhD, A. Bols MD, PhD, W. Lybaert MD, L. Duck MD, K. Jochmans MD, L. Bosquée MD, PhD, M. Peeters MD, PhD, A. Awada MD, PhD, P. Clement MD, PhD, S. Holbrechts MD, PhD, J-F. Baurain MD, PhD, J. Mebis MD, J. Nortier MD, PhD

Venous thromboembolism is a frequent cause of mortality and morbidity in patients with malignancy. Thrombosis is one of the leading causes of death in patients with malignancy after cancer itself. As such, prompt recognition and treatment of venous thromboembolism are required in order to reduce the risk of venous thromboembolism-related mortality. This report reviews the interrelationship between cancer, renal insufficiency and venous thromboembolism. The working group behind this review article concludes that low molecular weight heparins decrease the risk of recurrent venous thrombosis in cancer patients without increasing major bleeding complications. Low molecular weight heparins are therefore recommended as first line antithrombotic treatment in cancer patients with a clear clinical benefit. In patients with renal dysfunction, who are at increased risk of bleeding and of thrombotic complications, preference should be given to unfractionated heparin or a low molecular weight heparin with a mean molecular weight such as tinzaparin, having less risk of plasma accumulation and offering the possibility to maintain full therapeutic dose.

(BELG J MED ONCOL 2015;9(2):53–60)

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