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Maurizot A, Bura-Rivière A, Gritli K, Bertoletti L, Hernández-Blasco L, Ciammaichella M, Díaz-Pedroche MC, Alfonso M, Lorente MA, Monreal M. [Venous thromboembolic disease: Comparison of management practices in France, Italy and Spain]. JOURNAL DE MÉDECINE VASCULAIRE 2017; 42:6-13. [PMID: 28705449 DOI: 10.1016/j.jdmv.2017.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/25/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many national and international guidelines have been established for venous thromboembolic disease (VTE). Homogeneous management practices could be expected in the different European countries. To verify this hypothesis, we compared practices in France, Italy and Spain. METHOD We used data from the international RIETE registry to compare VTE management between France, Italy and Spain. RESULTS From 2001 January to 2011 January, patients were consecutively included in France (n=1548), Italy (n=2083) and Spain (29,824). All patients received anticoagulant treatment. Low molecular-weight heparin (LMWH) was the most frequently used drug as initial therapy in all three countries, but unfractionated heparin (UFH) was more frequently used in France and Italy than in Spain. In France, the proportion of patients receiving LMWH was lower than the proportion of patients with active cancer (cancer 22.5 %, long-term treatment with LMWH 17.4 %). A vena cava filter was significantly more frequently used in France (5.5 % in France, 3.2 % in Italy and 2 % in Spain, P<0.0001). High bleeding risk because of surgery with recent thromboembolic disease was the most frequent indication in France and Italy for vena cava filter placement (36.4 %, and 31.3 %, respectively). CONCLUSION Despite the publication of national and international guidelines, VTE management differs among the three major European countries included in the RIETE registry, France, Italy and Spain.
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Affiliation(s)
- A Maurizot
- Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Consultations de médecine vasculaire, Centre cardiologique du Nord, 32-36, rue des Moulins-Gémeaux, 93200 Saint-Denis, France.
| | - A Bura-Rivière
- Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - K Gritli
- Service de médecine vasculaire, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Centre de consultation médicale spécialisée Delta Medical, rue Habib Chatti, Manar II, Tunis, Tunisie
| | - L Bertoletti
- SAINBIOSE, DVH, Inserm, département de médecine et thérapeutique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - L Hernández-Blasco
- ISABIAL, Department of Clinical Medicine, Universidad Miguel Hernández, Hospital General Universitario Alicante, Alicante, Espagne
| | - M Ciammaichella
- Department of Emergency Internal Medicine, Ospedale St. John, Rome, Italie
| | - M C Díaz-Pedroche
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Espagne
| | - M Alfonso
- Department of Pneumonology, Complejo Hospitalario de Navarra, Pamplona, Espagne
| | - M A Lorente
- Department of Internal Medicine. Hospital de la Agencia Valenciana de Salud Vega Baja, Alicante, Espagne
| | - M Monreal
- Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Murcia, Espagne
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Zoubian A, Bertoletti L, Frappé P. After deep vein thrombosis, which patients refer to vascular specialist for anticoagulant withdrawal? A Delphi study results between general practitioners and vascular specialists. Presse Med 2017; 46:e77-e83. [PMID: 28483284 DOI: 10.1016/j.lpm.2016.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/27/2016] [Accepted: 07/28/2016] [Indexed: 11/29/2022] Open
Abstract
AIM Deep vein thrombosis (DVT) is a potential serious common disease. Its management is, except in particular cases, on an outpatient basis. General practitioner's (GP) role usually includes the treatment risk/benefit reassessment. The treatment duration can vary and is difficult to define. The national and international guidelines do not explain clearly when to refer, or not, to a vascular specialist in order to stop treatment. The study's objective was to identify, for DVT, when a GP has to refer or not to a vascular specialist, for anticoagulant withdrawal. METHODS A modified Delphi consensus study had been conducted by a panel of general practitioners and vascular specialists to identify, in which situations all clinicians agree that GPs can stop anticoagulation on their own and other situations in which GP have to refer to vascular specialists. Clinical situations and their respective duration of anticoagulant therapy have been identified by a DVT management guideline literature research. RESULTS After two rounds, a strong agreement had been reached for each clinical situation. For 7 clinical situations, GPs were able to stop anticoagulation on their own, for 13 clinical situations; it was necessary to refer to a vascular specialist. We obtained a consensus regarding 3 modulating factors. DISCUSSION Consensual situations, in which the general practitioners may be able to stop anticoagulation themselves, are isolated distal DVT without cancer and proximal DVT caused by a major reversible risk factor. Situations justifying a vascular medical advice were unprovoked DVT, DVT in a context of pregnancy, postpartum, cancer and proximal DVT in a context of hormonal therapy.
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Affiliation(s)
- Antonin Zoubian
- Université Jean-Monnet, faculté Jacques-Lisfranc, département de médecine générale, 42000 Saint-Étienne, France
| | - Laurent Bertoletti
- CHU Hôpital-Nord, CIE3, CIC-EC Inserm, 42000 Saint-Étienne, France; Université Jean-Monnet, Inserm U1059 Sainbiose-DVH, 42000 Saint-Étienne, France; CHU de Saint-Etienne, service de médecine vasculaire et thérapeutique, 42000 Saint-Étienne, France
| | - Paul Frappé
- Université Jean-Monnet, faculté Jacques-Lisfranc, département de médecine générale, 42000 Saint-Étienne, France; CHU Hôpital-Nord, CIE3, CIC-EC Inserm, 42000 Saint-Étienne, France; Université Jean-Monnet, Inserm U1059 Sainbiose-DVH, 42000 Saint-Étienne, France.
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3
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Abstract
Cancer is one the most prevalent risk factors in patients diagnosed with deep vein thrombosis or pulmonary embolism. Patients with cancer and venous thromboembolism have a higher risk of mortality when compared to patients with cancer without venous thromboembolism and a higher risk of recurrent thrombosis when compared with patients with venous thromboembolism without cancer. This increased risk of recurrence is not only observed after anticoagulant treatment is stopped, but also during anticoagulant treatment. Clinical trials have shown that the use of low molecular weight heparin during the first three to six months after venous thrombosis in patients with cancer is associated with a significantly lower risk of recurrence than the use of vitamin K antagonists and, thus, low molecular weight heparin is currently recommended as the treatment of choice by international guidelines. Unfortunately, the optimal management of recurrent venous thromboembolism during anticoagulant treatment remains poorly defined. In general, patients should firstly be assessed for treatment compliance, for the occurrence of heparin-induced thrombocytopenia, and for the presence of mechanical compression from tumour masses. Possible strategies include switching to a different anticoagulant drug, in particular from vitamin K antagonists to low molecular weight heparin; increasing the dose of the anticoagulant drug; or inserting an inferior vena cava filter. The results of recent registries show that the current approach to cancer patients with recurrent venous thromboembolism in routine clinical practice is highly heterogeneous.
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Affiliation(s)
- Erica Romualdi
- Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | - Walter Ageno
- Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
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Cui L, Sun YH, Chen J, Wang L, Liu JJ, Zhou XR, Ding J, Liu XX, Huang XE. Analysis of Prethrombotic States in Patients with Malignant Tumors. Asian Pac J Cancer Prev 2016. [PMID: 26225697 DOI: 10.7314/apjcp.2015.16.13.5477] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to investigate the incidence and risk factors for a prethrombotic state in patients with malignant tumors. MATERIALS AND METHODS Plasma d-dimer (D-D) in patients with malignant tumors was measured. Abnormal rates of D-D and possible risk factors like gender, age, type of tumor, and staging of tumor were analyzed. RESULTS Of 1,453 patients, 629 demonstrated plasma D-D abnormality (43.3%). The D-D abnormal rate of male patients (n=851, 43.5%) was not statistically significantly different from that for female patients (n=602, 43.0%) (p>0.05). D-D abnormal rate increased with age and was statistically significant among different age groups (p<0.05). Regarding staging of tumor, D-D abnormal rate in patients with phase I was 2.0%, 6.2% in phase II, 47.6% in phase III and 83.1% in phase IV, with statistically significant differences between phase III and II, as well as phase III and IV (p<0.01). CONCLUSIONS A prethrombotic state was closely related to malignancy of tumors. The risk factors for a prethrombotic state include age and tumor stage.
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Affiliation(s)
- Lin Cui
- Department of Oncology, Taizhou Second People's Hospital, the Affiliated Hospital of Yangzhou University, Taizhou, China E-mail :
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Lee AY, Peterson EA, Wu C. Clinical practice guidelines on cancer-associated thrombosis: a review on scope and methodology. Thromb Res 2016; 140 Suppl 1:S119-27. [DOI: 10.1016/s0049-3848(16)30110-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Segraves JM, Daniels CE. Pulmonary embolus diagnosed by endobronchial ultrasound. Respir Med Case Rep 2015; 16:104-5. [PMID: 26744670 PMCID: PMC4681961 DOI: 10.1016/j.rmcr.2015.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 08/11/2015] [Indexed: 12/02/2022] Open
Abstract
Endobronchial ultrasound (EBUS) imaging is commonly used to evaluate and aid in biopsy of mediastinal lymph nodes. Pulmonary arteries are readily viewable with this type of imaging modality. We present a case report of a pulmonary embolism (PE) diagnosed by EBUS. Our patient had no smoking history and presented with respiratory and constitutional symptoms, urinary retention, and leg weakness suspicious for malignancy with metastasis to spine. Chest computed tomography (CT) was suggestive of lung carcinoma and specifically showed no PE. EBUS with TBNA was requested for tissue diagnosis. A mobile filling defect consistent with a PE was observed and reported to primary team. Follow-up chest CT showed an acute PE which confirmed the diagnosis originally made by EBUS. Bronchoscopists should be aware of potential to diagnose a PE while performing EBUS. Additionally, there may be a role in using EBUS specifically to diagnose a PE in the right patient population.
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Affiliation(s)
| | - Craig E Daniels
- Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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Wilts IT, Bleker SM, Van Es N, Büller HR, Di Nisio M, Kamphuisen PW. Safety of anticoagulant treatment in cancer patients. Expert Opin Drug Saf 2015; 14:1227-36. [DOI: 10.1517/14740338.2015.1052739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Schulman S, Zondag M, Linkins L, Pasca S, Cheung YW, de Sancho M, Gallus A, Lecumberri R, Molnar S, Ageno W, Le Gal G, Falanga A, Hulegårdh E, Ranta S, Kamphuisen P, Debourdeau P, Rigamonti V, Ortel TL, Lee A. Recurrent venous thromboembolism in anticoagulated patients with cancer: management and short-term prognosis. J Thromb Haemost 2015; 13:1010-8. [PMID: 25851122 DOI: 10.1111/jth.12955] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/29/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recommendations for management of cancer-related venous thromboembolism (VTE) in patients already receiving anticoagulant therapy are based on low-quality evidence. This international registry sought to provide more information on outcomes after a breakthrough VTE in relation to anticoagulation strategies. METHODS Patients with cancer and VTE despite anticoagulant therapy were reported to the registry. Data on treatments, VTE events, major bleeding, residual thrombosis symptoms and death were collected for the following 3 months. Breakthrough VTE and subsequent recurrences were objectively verified. Outcomes with different treatment strategies were compared with Cox proportional hazards regression. RESULTS We registered 212 patients with breakthrough VTE. Of those, 59% had adenocarcinoma and 73% had known metastases. At the time of the breakthrough event, 70% were on low-molecular-weight heparin (LMWH) and 27% on a vitamin K antagonist (VKA); 70% had a therapeutic or supratherapeutic dose. After breakthrough the regimen was: unchanged therapeutic dose in 33%, dose increased in 31%, switched to another drug in 24%; and other management in 11%. During the following 3 months 11% had another VTE, 8% had major bleeding and 27% died. Of the survivors, 74% had residual thrombosis symptoms. Additional VTE recurrence was less common with LMWH than with a VKA (hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.11-0.70) but similar with unchanged or increased anticoagulant intensity (HR, 1.09; 95% CI, 0.45-2.63). The bleeding rate did not increase significantly with dose escalation. CONCLUSION Morbidity and mortality are high after recurrence of cancer-related VTE despite anticoagulation. Further treatment appears to be more effective with LMWH than with a VKA.
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Affiliation(s)
- S Schulman
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Karolinska Institutet, Stockholm, Sweden
| | - M Zondag
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - L Linkins
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - S Pasca
- Center for Hemorrhagic and Thrombotic Disease, University Hospital of Udine, Udine, Italy
| | - Y W Cheung
- Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - M de Sancho
- Weill Cornell Medical College, New York, NY, USA
| | - A Gallus
- Flinders University, Adelaide, SA, Australia
| | - R Lecumberri
- Hematology Service, University Clinic of Navarra, Pamplona, Spain
| | - S Molnar
- Oncology and Hematology Department, Sanatorio Allende, Cordoba, Argentina
| | - W Ageno
- Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | - G Le Gal
- Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France
| | - A Falanga
- Department of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - E Hulegårdh
- Department of Hematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S Ranta
- Karolinska Institutet, Stockholm, Sweden
| | - P Kamphuisen
- Department of Vascular Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - P Debourdeau
- Oncology Department, Ste Catherine Institute, Avignon, France
| | | | - T L Ortel
- Division of Hematology, Duke University Medical Center, Durham, NC, USA
| | - A Lee
- Diamond Health Care Centre, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
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9
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Bauersachs RM. Guidelines for the management of cancer and thrombosis – Special aspects in women. Thromb Res 2015; 135 Suppl 1:S16-22. [DOI: 10.1016/s0049-3848(15)50434-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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10
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Abstract
Thrombosis is a common complication in patients with acute leukemia. While the presence of central venous lines, concomitant steroids, the use of Escherichia coli asparaginase and hereditary thrombophilic abnormalities are known risk factors for thrombosis in children, information on the pathogenesis, risk factors, and clinical outcome of thrombosis in adult patients with acute lymphoid leukemia (ALL) or acute myeloid leukemia (AML) is still scarce. Expert consensus and guidelines regarding leukemia-specific risk factors, thrombosis prevention, and treatment strategies, as well as optimal type of central venous catheter in acute leukemia patients are required. It is likely that each subtype of acute leukemia represents a different setting for the development of thrombosis and the risk of bleeding. This is perhaps due to a combination of different disease-specific pathogenic mechanisms of thrombosis, including the type of chemotherapy protocol chosen, the underlying patients health, associated risk factors, as well as the biology of the disease itself. The risk of thrombosis may also vary according to ethnicity and prevalence of hereditary risk factors for thrombosis; thus, it is advisable for Latin American, Asian, and African countries to report on their specific patient population.
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Affiliation(s)
- Erick Crespo-Solís
- Clínica de Leucemia Aguda, Departamento de Hematología y Oncología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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11
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Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ, Svensson PJ, Veenstra DL, Crowther M, Guyatt GH. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e152S-e184S. [PMID: 22315259 DOI: 10.1378/chest.11-2295] [Citation(s) in RCA: 882] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND High-quality anticoagulation management is required to keep these narrow therapeutic index medications as effective and safe as possible. This article focuses on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices. METHODS The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. RESULTS Most practical clinical questions regarding the management of anticoagulation, both oral and parenteral, have not been adequately addressed by randomized trials. We found sufficient evidence for summaries of recommendations for 23 questions, of which only two are strong rather than weak recommendations. Strong recommendations include targeting an international normalized ratio of 2.0 to 3.0 for patients on vitamin K antagonist therapy (Grade 1B) and not routinely using pharmacogenetic testing for guiding doses of vitamin K antagonist (Grade 1B). Weak recommendations deal with such issues as loading doses, initiation overlap, monitoring frequency, vitamin K supplementation, patient self-management, weight and renal function adjustment of doses, dosing decision support, drug interactions to avoid, and prevention and management of bleeding complications. We also address anticoagulation management services and intensive patient education. CONCLUSIONS We offer guidance for many common anticoagulation-related management problems. Most anticoagulation management questions have not been adequately studied.
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Affiliation(s)
- Anne Holbrook
- Division of Clinical Pharmacology and Therapeutics, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Department of Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
| | - Sam Schulman
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Daniel M Witt
- Department of Pharmacy, Kaiser Permanente Colorado, Denver, CO
| | - Per Olav Vandvik
- Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | - Jason Fish
- Department of Internal Medicine, University of California Los Angeles, Los Angeles, CA
| | - Michael J Kovacs
- Department of Medicine, University of Western Ontario, London, ON, Canada
| | - Peter J Svensson
- Department for Coagulation Disorders, University of Lund, University Hospital, Malmö, Sweden
| | | | - Mark Crowther
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gordon H Guyatt
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Department of Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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Incidence and risk factors for developing venous thromboembolism in Japanese with diffuse large b-cell lymphoma. Thromb Res 2011; 130:7-11. [PMID: 22000981 DOI: 10.1016/j.thromres.2011.09.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 08/30/2011] [Accepted: 09/20/2011] [Indexed: 12/21/2022]
Abstract
The reported incidence of venous thromboembolism (VTE) in lymphoma patients is 5% to 17% in Western countries. The incidence and risk factors for developing VTE, however, are not well elucidated in Asian lymphoma patients. The incidence and clinical presentations of VTE were retrospectively assessed in 142 patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL) from April 2006 to November 2010 at Keio University Hospital. Clinical data were collected and all episodes of symptomatic VTE confirmed by imaging were included. Patients with primary central nervous system lymphoma or DLBCL transformed from prior low-grade lymphoma were excluded. Fifteen (11%) patients had at least one episode of VTE. Five patients developed VTE before beginning chemotherapy and 8 episodes of VTE occurred during the first three cycles of chemotherapy. By univariate analysis, age 60 or over (odds ratio [OR] 4.81, confidence interval [CI] 1.04-22.20, p=0.04), Eastern Cooperative Oncology Group performance status 2, 3, or 4 (OR 39.90, CI 5.05-315.20, p=0.0005), and International Prognostic Index high or high-intermediate (OR 9.40, CI 1.20-73.69, p=0.03) were identified as risk factors for developing VTE. By multivariate analysis, performance status 2, 3, or 4 remained a significant risk factor for developing VTE (OR 31.14, CI 3.79-255.62, p=0.001). The incidence of VTE in Japanese with DLBCL was comparable with that in the Western population. Patients with DLBCL and poor performance status at diagnosis were at high risk for developing VTE especially early in the course of treatment.
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Akahane A, Sone M, Ehara S, Kato K, Tanaka R, Nakasato T. Subclavian Vein Versus Arm Vein for Totally Implantable Central Venous Port for Patients with Head and Neck Cancer: A Retrospective Comparative Analysis. Cardiovasc Intervent Radiol 2010; 34:1222-9. [DOI: 10.1007/s00270-010-0051-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2010] [Accepted: 11/09/2010] [Indexed: 10/18/2022]
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Câncer e TEP. J Bras Pneumol 2010. [DOI: 10.1590/s1806-37132010001300019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Sandset PM, Francis C, Key N. Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thromb Res 2009; 124:515. [PMID: 19837232 DOI: 10.1016/j.thromres.2009.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 08/10/2009] [Accepted: 09/14/2009] [Indexed: 12/11/2022]
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