Med. Pro Praxi 2009; 6(1): 22-24

Thrombosis and sarcomas

MUDr. Petr Kessler^1,2

¹ Oddělení hematologie a transfuziologie, Nemocnice Pelhřimov, p.o

² Odddělení hematologie a transfuziologie, Nemocnice Pelhřimov, p.o

Guidelines for clinical practice are formulated in the article: 1. Patients with idiopathic venous thromboembolism (VTE) should be evaluated

for cancer. The examination including history, physical examination, chest X-ray, abdominal and pelvic ultrasonography, PSA testing

in men and pelvic examination and mammography in women seems be appropriate. Additional testing (CT and endoscopy) should be

indicated only in case of suspicion of cancer. 2. For patients undergoing cancer surgery, pharmacological prophylaxis is recommended.

Low molecular weight heparins (LMWHs), unfractionated heparin (UFH) 5 000 U three times a day, or fondaparinux can be used; LMWHs

are most suitable in Czech Republic. For patients undergoing major cancer surgery extended prophylaxis for 4 weeks is recommended.

Intermittent pneumatic compression is a reasonable alternative for patients who have a high risk of bleeding. 3. For cancer patients, who

are bedridden, or hospitalized with an acute illness, thromboprophylaxis with LMWH is recommended. Patients with multiple myeloma,

undergoing induction therapy, including 2 or more thrombogenic drugs (thalidomide, lenalidomide, dexamethasone, prednison, and

anthracyclines) should be treated with LMWH. In other cancer patients, pharmacological thromboprophylaxis is not generally recommended,

however, thromboprophylaxis should be considered in patients with history of VTE, or with multiple risk factors.

Keywords: cancer, thromboprophylaxis, heparin, low molecular heparin.

Published: March 1, 2009  Show citation