350 rub
Journal Technologies of Living Systems №3 for 2013 г.
Article in number:
Abnormalities of hemostasis and vte in cancer patients
Keywords: cancer haemostasis thrombosis LMWH
Authors:
O.V. Somonova, A.V. Madzhuga, A.L. Elizarova
Abstract:
Cancer tumor elevates risk of venous thromboembolism (VTE) and pulmonary embolism in 4-7 time. The main role in pathogenesis of thrombotic complication in cancer patients is changes in the hemostatic sistem caused by the tumor itself as well as methods of treatment. The use of LMWH before and after operation (7-20 days) reduces the activation of pro-coagulation (prolongation of APTT, decrease in prothrombin activity and of fibrinogen concentration) and platelet links of hemostasis system, the level of intravascular coagulation markers (D-dimers, fibrin monomers soluble complex) and von Willebrand factor. The LMWH conduces preservation of natural inhibitor of thrombin (antithrombin III, protein C), maintains the defensive role of fibrinolysis. In patients with tumors of the musculoskeletal system VTE developed in 13% of cases in control group versus 2% of cases in group, receiving enoxaparin sodium thromboprophylaxis. In gynecological cancer patients VTE developed in 13% of cases in control group versus 6% of cases in group, receiving nadroparin thromboprophylaxis, and 5% of cases in group, receiving enoxaparin sodium thromboprophylaxis. In patients with cancer receiving antitumor therapy, increased the intensity of intravascular coagulation: Use of LMWH together with antitumor therapy decreased the intensity of intravascular coagulation and the rate of thrombotic events; thrombosis developed in 21% in the control group versus 4% in patients receiving LMWH.
Pages: 70-78
References
  1. Agnelli G., Verso M. Management of venous thromboembolism in patients with cancer // J. Thromb. Haemost. 2011. V. 9. Suppl. 1. P. 316 - 324.
  2. Zwicker J.I. Predictive value of tissue factor bearing microparticles in cancer associated thrombosis // Thrombos. Research. 2010. V. 125. Suppl. 2. P. 89 ? 91.
  3. Nicolaides A.N.Prevention and treatment of venous thromboembolism. International Consensus Statement. Guidelines according to scientific evidence // Int. Angiol. 2006. V. 25. P. 101 - 161.
  4. Ten C.H., Falanga A. Overview of the postulated mechanisms linking cancer and thrombosis // Pathophysiol. Haemost. Thromb. 2007. V. 36. P. 122 - 130.
  5. Smorenburg S.M., Hutten B.A., Prins M.N. Should patients with venous thromboembolism and cancer be treated differently - // Haemostasis. 1999. V. 29 (Suppl.) P. 91 - 97.
  6. Levine M.N., Lee A.Y., Kakkar A.K. Thrombosis and cancer // Amer. Society Clin. Oncol. Ann. Meeting. 2005. V. 41. P. 748 - 577.
  7. Hillen H.F. Thrombosis in cancer patients // ESMO. Ann. Oncol. 2000. V. 11. Suppl. 3. P. 273 - 276.
  8. Hirsh J., Anand S.S., Halperin J.L., Fuster V. Guide to Anticoagulant therapy: Heparin. A Statement for healthcare Professionals from the American Heart Association // Curculation. 2001. V. 105. P. 2994 - 3018.
  9. Arcelus J.I. Recognizing the risk of VTE in surgical patients // International Surgical Thrombosis Meeting -Optimizing VTE Management in surgical patients - (abstract). Greece. 2007. P. 13 - 17.
  10. Cohen A.T., Nandini B., Wills J.O. et al. VTE prophylaxis for the medical patients: where do we stand?- A focus on cancer patients // Thrombosis Res. 2010.  V. 125. Suppl. 2. P. 21 - 29.
  11. Lip G.Y., Chin B.S., Blann A.D. Cancer and the prothrombotic state // Lancet Oncol. 2002. V. 3. P. 26 - 34.
  12. Amin C., Mackman N., Key N.C. Microparticles and cancer // Pathophysiol. Haemost. Thromb. 2008.
    V. 36. P. 177 - 183.
  13. Simanek R., Vormittag R., Alguel G. et al. A high platelet count independently predicts venous thromboembolism in cancer patients // J. Thromb. Haemost. 2007. V. 5. Suppl. 2. P. 493 - 497.
  14. Chand H.S., Ness A., Kisiel W. Identification of a novel human tissue factor splice variant that is upregulated in tumor cells // Int. J. Cancer. 2006. V. 118.  P. 1713 - 1720.
  15. Buller H.R., van Doormaal F.F., van Sluis G.L. et al.Cancer and thrombosis: from molecular mechanism to clinical presentations // J. Thromb. Haemost. 2007. V. 5. Suppl. 1. P. 246 - 254.
  16. Petralia G.A., Lemoine N.R., Kakkar A.K. Mechanisms of disease: the impact of antithrombotic therapy in cancer patients // Nat. Clin. Pract. Oncol. 2005. V. 2.
    P. 356 - 363.
  17. Varki A. Trousseau\'s syndrome: multiple definitions and multiple mechanisms // Blood. 2007. V. 110.
    P. 1723 - 1729.
  18. Ten C.H., Falanga A. Overview of the postulated mechanisms linking cancer and thrombosis // Pathophysiol. Haemost. Thromb. 2007. V. 36. P. 122 - 130.
  19. Agnelii G., Verso M. Thromboprophylaxis during chemotherapy in patients with advanced cancer // Thromb. Res. 2010. Vol. 125. Suppl. 2. P. 17 - 20.
  20. Mandala M., Labianca R. Venous thromboembolism (VTE) in cancer patients. ESMO Clinical Recommendations for prevention and management // Thromb. Res. 2010. V. 125. Suppl. 2. P. 117 - 119.
  21. Lee A.Y. The roles of anticoagulants in patients with cancer // Thromb. Res. 2010. V. 125. Suppl. 2. P. 8 - 11.
  22. Agnelii G., Bergqvist D., Cohen A. et al.Randomized double-blind study to compare the efficacy and safety of postoperative fondaparinux (Arixtra) and preoperative dalteparin in the prevention of venous thromboembolism after high risk abdominal surgery: the PEGASUS Study (abstract) // Blood. 2003. V.102. P. 15 - 18.
  23. Connoly G.C., Khorana A.A. Emerging risk stratification approaches to cancer -associated thrombosis: risk factors, biomarkers and a risk score // Thrombosis Res. 2010. V. 125. Suppl. 2. P. 1 - 8.
  24. Bloom J.W., Vanderschoot J.P., Oostindier M.J. et al.Incidence of venous thrombosis in a large cohort of 66329 cancer patients: results of a record linkage study //
    J. Thromb. Haemost. 2006. V. 4. P. 529 - 535.
  25. Otten H.M., Mathijssen J., Ten C.H. et al.Symptomatic venous thromboembolism in cancer patients treated with chemotherapy: an underestimated phenomenon // Arch. Inter. Med. 2004. V. 164. P. 190 - 194.
  26. Mimetic P., Laborite S., Damon J.Y. et al. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery // Br. J. Surg. 2001. V. 88. P. 913 - 930.
  27. Caprini J.A., Botteman M.F., Stephens J.M. et al. Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States // Value Health. 2003. V. 6. P.59 - 74.
  28. Becker R.C., Fintel D.J., Green D. Antithrombotic therapy (2th ed). USA. 2002. 352 p.