Primary prevention and research progress of venous thromboembolism in patients with cancer
-
摘要: 肿瘤相关静脉血栓栓塞症（cancer-associated venous thromboembolism，CAVTE）是肿瘤患者常见的并发症和死亡原因。因此，如何预防CAVTE的发生受到越来越多的关注。预防性抗凝治疗可以降低肿瘤患者的血栓发生风险，因此需要将患者的获益和不良反应进行充分评估，排除抗凝治疗禁忌后，对血栓高危患者进行预防性的抗凝治疗。
-
关键词:
- 肿瘤相关静脉血栓栓塞症 /
- 血栓预防 /
- 低分子肝素 /
- 新型口服抗凝药 /
- 肿瘤心脏病学
Abstract: Cancer-associated venous thromboembolism (VTE) is a common complication and cause of death in patients with cancer. Therefore, strategies to prevent the occurrence of VTE have increasingly attracted attention. Prophylactic anticoagulant therapy can reduce the risk of VTE in patients with cancer. It is necessary to completely evaluate the benefits and potential adverse reactions and eliminate any contraindications of anticoagulant therapy before prophylactic anticoagulant therapy is administered to high-risk patients. -
表 1 Khorana血栓风险评估模型[17]
表 2 新型口服抗凝药用于门诊肿瘤患者的一级预防研究[20]
-
[1] 中国健康促进基金会血栓与血管专项基金专家委员会, 中华医学会呼吸病学分会肺栓塞与肺血管病学组, 中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会.医院内静脉血栓栓塞症防治与管理建议[J].中华医学杂志, 2018, 98(18):1383-1388. doi: 10.3760/cma.j.issn.0376-2491.2018.18.003 [2] Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism[J]. J Thromb Thrombolysis, 2016, 41(1):3-14. http://d.old.wanfangdata.com.cn/OAPaper/oai_pubmedcentral.nih.gov_1924698 [3] Noble S, Pasi J. Epidemiology and pathophysiology of cancer-associated thrombosis[J]. Br J Cancer, 2010, (102 Suppl 1):S2-S9. http://d.old.wanfangdata.com.cn/OAPaper/oai_pubmedcentral.nih.gov_3315367 [4] Khorana AA. Venous thromboembolism and prognosis in cancer[J]. Thrombosis research, 2010, 125(6):490493. http://d.old.wanfangdata.com.cn/Periodical/zhyx201812006 [5] 中国临床肿瘤学会肿瘤与血栓专家委员会.肿瘤相关静脉血栓栓塞症预防与治疗指南(2019版)[J].中国肿瘤临床, 2019, 46(13):653-660. doi: 10.3969/j.issn.1000-8179.2019.13.765 [6] Akl EA, Kahale L, Sperati F, et al. Low molecular weight heparin versus unfractionated heparin for perioperative thromboprophylaxis in patients with cancer[J]. Cochrane Database Syst Rev, 2014, (6):CD009447. http://cn.bing.com/academic/profile?id=95ad8234596a1146727ed13bd4b60c75&encoded=0&v=paper_preview&mkt=zh-cn [7] Akl EA, Terrenato I, Barba M, et al. Low-molecular-weight heparin vs unfractionated heparin for perioperative thromboprophylaxis in patients with cancer:a systematic review and meta-analysis[J]. Arch Intern Med, 2008, 168:1261-1269. doi: 10.1001/archinte.168.12.1261 [8] Guo Q, Huang B, Zhao J, et al. Perioperative pharmacological thromboprophylaxis in patients with cancer:a systematic review and meta-analysis[J]. Ann Surg, 2017, 265:1087-1093. doi: 10.1097/SLA.0000000000002074 [9] Pariser JJ, Pearce SM, Anderson BB, et al. Extended duration enoxaparin decreases the rate of venous thromboembolic events after radical cystectomy compared to inpatient only subcutaneous heparin[J]. J Urol, 2017, 197:302-307. doi: 10.1016/j.juro.2016.08.090 [10] Carrier M, Altman AD, Blais N, et al. Extended thromboprophylaxis with low-molecular weight heparin (LMWH) following abdominopelvic cancer surgery[J]. Am J Surg, 2019, 218(3):537-550. doi: 10.1016/j.amjsurg.2018.11.046 [11] Khorana AA, Francis CW, Culakova E, et al. Thromboembolism in hospitalized neutropenic cancer patients[J]. J Clin Oncol, 2006, 24(3):484-490. doi: 10.1200/JCO.2005.03.8877 [12] NCCN Clinical Practice Guidelines in Oncology-Cancer-Associated Venous Thromboembolic Disease. (2019 Version I)[DB/OL]. https://www.nccn.org/professionals/physician_gls/pdf/vte.pdf [13] Haas SK, Freund M, Heigener D, et al. Low-molecular-weight heparin versus placebo for the prevention of venous thromboembolism in metastatic breast cancer or stage Ⅲ/Ⅳ lung cancer[J]. Clin Appl Thromb Hemost, 2012, 18(2):159-165. doi: 10.1177/1076029611433769 [14] Agnelli G, George DJ, Kakkar AK, et al. Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer[J]. N Engl J Med, 2012, 366(7):601-609. doi: 10.1056/NEJMoa1108898 [15] Maraveyas A, Waters J, Roy R, et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer[J]. Eur J Cancer, 2012, 48(9):1283-1292. doi: 10.1016/j.ejca.2011.10.017 [16] Pelzer U, Opitz B, Deutschinoff G, et al. Efficacy of prophylactic lowmolecular weight heparin for ambulatory patients with advanced pancreatic cancer:outcomes from the CONKO-004 Trial[J]. J Clin Oncol, 2015, 33(18):2028-2034. doi: 10.1200/JCO.2014.55.1481 [17] Khorana AA, Kuderer NM, Culakova E, et al. Development and validation of a predictive model for chemotherapy-associated thrombosis[J]. Blood, 2008, 111(10):4902-4907. doi: 10.1182/blood-2007-10-116327 [18] Khorana AA, Soff GA, Kakkar AK, et al. Rivaroxaban for thromboprophylaxis in high-risk ambulatory patients with cancer[J]. N Engl J Med, 2019, 380:720-728. doi: 10.1056/NEJMoa1814630 [19] Wang ZF, Zwicker JI, Cihan AY, et al. The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients:Guidance from the SSC of the ISTH[J]. J Thrombosis and Haemostasis, 2019, 17(7):1-7. doi: 10.1111/jth.14179 [20] Carrier M, Abou-Nassar K, Mallick R, et al. Apixaban to prevent venous thromboembolism in patients with cancer[J]. N Engl J Med, 2019, 380:711-719. doi: 10.1056/NEJMoa1814468 [21] Caprini JA, Arcelus JI, Reyna JJ. Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease[J]. Semin Hematol, 2001, 38(2 suppl 5):12-19. http://cn.bing.com/academic/profile?id=4c51dcd891a4e876bc9f4bfd0eb95fd6&encoded=0&v=paper_preview&mkt=zh-cn [22] Barbar S, Noventa F, Rossetto V, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism:the Padua Prediction Score[J]. J Thromb Haemost, 2010, 8(11):2450-2457. doi: 10.1111/j.1538-7836.2010.04044.x [23] Verso M, Agnelli G, Barni S, et al. A modified Khorana risk assessment score for venous thromboembolism in cancer patients receiving chemotherapy:The protect score[J]. Intern Emerg Med, 2012, (7):291-292. https://www.ncbi.nlm.nih.gov/pubmed/22547369 [24] Ay C, Dunkler D, Marosi C, et al. Prediction of venous thromboembolism in cancer patients[J]. Blood, 2010, 116:5377-5382. doi: 10.1182/blood-2010-02-270116 [25] Akl EA, Vasireddi SR, Gunukula S, et al. Anticoagulation for patients with cancer and central venous catheters[J]. Cochrane Database Syst Rev, 2011, 16(2):CD006468. http://cn.bing.com/academic/profile?id=848373c386570286aadec1a1b69441ca&encoded=0&v=paper_preview&mkt=zh-cn [26] Couban S, Goodyear M, Burnell M, et al. Randomized placebo-controlled study of low-dose warfarin for the prevention of central venous catheter-associated thrombosis in patients with cancer[J]. J Clin Oncol, 2005, 23(18):4063-4069. doi: 10.1200/JCO.2005.10.192 [27] Verso M, Agnelli G, Bertoglio S, et al. Enoxaparin for the prevention of venous thromboembolism associated with central vein catheter:a double-blind, placebo-controlled, randomized study in cancer patients[J]. J Clin Oncol, 2005, 23(18):4057-4062. doi: 10.1200/JCO.2005.06.084 [28] Karthaus M, Kretzschmar A, Kroning H, et al. Dalteparin for prevention of catheter-related complications in cancer patients with central venous catheters:final results of a double-blind, placebocontrolled phase Ⅲ trial[J]. Ann Oncol, 2006, 17(2):289-296. doi: 10.1093/annonc/mdj059 [29] Akl EA, Kahale L, Barba M, et al. Anticoagulation for the long-term treatment of venous thromboembolism in patients with cancer[J]. Cochrane Database Syst Rev, 2014, (7):CD006650. http://cn.bing.com/academic/profile?id=a43e2eac4a8ee77bf95568d7f13ffa03&encoded=0&v=paper_preview&mkt=zh-cn [30] Lavau-Denes S, Lacroix P, Maubon A, et al. Prophylaxis of catheterrelated deep vein thrombosis in cancer patients with low-dose warfarin, low molecular weight heparin, or control:a randomized, controlled, phase Ⅲ study[J]. Cancer Chemother Pharmacol, 2013, 72(1):65-73. doi: 10.1007/s00280-013-2169-y [31] Lee AY, Levine MN, Butler G, et al. Incidence, risk factors, and outcomes of catheter-related thrombosis in adult patients with cancer[J]. J Clin Oncol, 2006, 24(9):1404-1408. doi: 10.1200/JCO.2005.03.5600 [32] Catovsky D, Ikoku NB, Pitney WR, et al. Thromboembolic complications in myelomatosis[J]. Br Med J, 1970, 3(5720):438-439. doi: 10.1136/bmj.3.5720.438 [33] Dimopoulos M, Spencer A, Attal M, et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma[J]. N Engl J Med, 2007, 357(21):2123-2132. doi: 10.1056/NEJMoa070594 [34] Osman K, Comenzo R, Rajkumar SV. Deep venous thrombosis and thalidomide therapy for multiple myeloma[J]. N Engl J Med, 2001, 344(25):1951-1952. doi: 10.1056/NEJM200106213442516 [35] Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised international staging system for multiple myeloma:a report from International Myeloma Working Group[J]. J Clin Oncol, 2015, 33(26):2863-2869. doi: 10.1200/JCO.2015.61.2267 [36] Yu Y, Lv Q, Zhang B, et al. Adjuvant therapy with heparin in patients with lung cancer without indication for anticoagulants:a systematic review of the literature with meta-analysis[J]. J Cancer Res Ther, 2016, (12):37-42. http://cn.bing.com/academic/profile?id=9f8da458eb17b940cbf08f9548398b44&encoded=0&v=paper_preview&mkt=zh-cn [37] Fuentes HE, Oramas DM, Paz LH, et al. Meta-analysis on anticoagulation and prevention of thrombosis and mortality among patients with lung cancer[J]. Thromb Res, 2017, 154:28-34. doi: 10.1016/j.thromres.2017.03.024 [38] Thein KZ, Yeung SJ, Oo TH. Primary thromboprophylaxis (PTP) in ambulatory patients with lung cancer receiving chemotherapy:a systematic review and meta-analysis of randomized controlled trials (RCTs)[J]. Asia Pac J Clin Oncol, 2018, (14):210-216. http://cn.bing.com/academic/profile?id=574d441d9d3a7c8e95d5220277d6607b&encoded=0&v=paper_preview&mkt=zh-cn [39] Tun NM, Guevara E, Oo TH. Benefit and risk of primary thromboprophylaxis in ambulatory patients with advanced pancreatic cancer receiving chemotherapy:a systematic review and meta-analysis of randomized controlled trials[J]. Blood Coagul Fibrinolysis, 2016, 27:270-274. doi: 10.1097/MBC.0000000000000413 [40] Pelzer U, Opitz B, Deutschinoff G, et al. Efficacy of prophylactic lowmolecular weight heparin for ambulatory patients with advanced pancreatic cancer:outcomes from the CONKO-004 trial[J]. J Clin Oncol, 2015, 33:2028-2034. doi: 10.1200/JCO.2014.55.1481 [41] Maraveyas A, Waters J, Roy R, et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer[J]. Eur J Cancer, 2012, 48:1283-1292. doi: 10.1016/j.ejca.2011.10.017 [42] Marras LC, Geerts WH, Perry JR. The risk of venous thromboembolism is increased throughout the course of malignant glioma:An evidence-based review[J]. Cancer, 2000, 89:640-646. doi: 10.1002/1097-0142(20000801)89:3<640::AID-CNCR20>3.0.CO;2-E [43] Perry JR, Julian JA, Laperriere NJ, et al. PRODIGE:a randomized placebo-controlled trial of dalteparin low-molecular-weight heparin thromboprophylaxis in patients with newly diagnosed malignant glioma[J]. J Thromb Haemost, 2010, 8(9):1959-1965. doi: 10.1111/j.1538-7836.2010.03973.x -
点击查看大图
表(2)
计量
- 文章访问数: 129
- HTML全文浏览量: 23
- PDF下载量: 24
- 被引次数: 0
下载:
