DI-061 Cancer associated thrombosis: evaluation of an anticoagulation therapy approach in a medical oncology service

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Abstract

Background

Venous thromboembolism (VTE) is a frequent complication and leading cause of death in patients with cancer. The question of the optimal anticoagulation therapy for cancer patients suffering from VTE is an ongoing area of research and debate.

Purpose

The aim of our study was to evaluate anticoagulation therapy in cancer associated thrombosis patients with reference to current guidelines in the field.

Material and methods

We conducted a descriptive study including cancer patients who developed venous thrombosis between January 2015 and September 2016. Data collection was achieved using patients’ medical files. Current international guidelines in the field, such as recommendations of the ‘Groupe Francophone Thrombose et Cancer’ were consulted and compared with our service approach.

Results

In total, 25 patients were included. The majority were men (sex ratio (M/F)=1.27). Median age was 59 years (range 21–80). 19 cases of deep venous thrombosis, 4 of pulmonary embolisms and 3 of catheter associated thrombosis were diagnosed. As an initial treatment (first 5–10 days) of established VTE, 23 patients were treated with low molecular weight heparin (LMWH). Tinzaparin was prescribed in 22 cases. 2 patients received vitamin K antagonists (VKA). One of these 2 patients did not reach the target international normalised ratio (INR) range. Therefore, LMWH was substituted for VKA. For early maintenance and long term treatment, LMWH was used in 23 patients. The 2 other patients suffered from heparin induced thrombocytopenia during the initial treatment. As a result, LMWH was replaced by VKA. Duration of anticoagulation therapy varied from 2 to 18 months. 6 patients had complications of their VTE during treatment: 3 cases of VTE extension, 2 relapses and 1 case of pulmonary embolism.

Conclusion

According to our results, the therapeutic management of VTE in our service is globally comparable with current international recommendations. The optimal duration of treatment remains unclear. In our study, termination or continuation of anticoagulation was based on individual evaluation of the benefit–risk ratio, tolerability, patients’ preferences and cancer activity.

Conclusion

No conflict of interest

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