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Sebuhyan M, Crichi B, Deville L, Le Maignan C, Bonnet C, Marjanovic Z, Rueda J, Bensaoula O, Ndour A, Frere C, Madeleine I, Farge D. Patient education program at the forefront of cancer-associated thrombosis care. J Med Vasc 2021; 46:215-223. [PMID: 34862015 DOI: 10.1016/j.jdmv.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Treatment of cancer-associated thrombosis (CAT) requires specific approaches, although it is well codified in most cases. Current national and international (International Initiative on Cancer and Thrombosis, ITAC) Clinical Practice Guidelines (CPG) recommend the use of low-molecular-weight heparin (LMWH) over 6 months as first treatment option, and anticoagulation should be maintained thereafter as long as cancer is active. Since compliance improves when patients understand their disease and related treatments, we created a dedicated patient education program (PEP) for CAT, aiming to improve quality of care. METHODS Retrospective analysis of all patients who voluntarily joined the PEP for CAT from 2014 to 2020. RESULTS In total, 182 cancer patients (median age, 64.9 years) were included, 53.3% with metastatic disease. A total of 528 PEP sessions (median, 3 per patient) were delivered. After PEP completion, the rate of self-injections or those performed at home by a relative had increased from 49.1% to 59.8% (P=0.05). Quality of life had improved significantly (P=0.025) and 90.0% of patients reported adhering to anticoagulant therapy. CONCLUSION Implementation of a structured and personalized PEP for CAT is feasible, allowing to improve cancer patient empowerment, adherence to CAT treatment and quality of life. The Groupe francophone et cancer (GFTC) members aim at facilitating access to CAT-PEP for both patients and caregivers and use of the multi-language ITAC-CPG mobile app (free access: www.itaccme.com) to improve the care and quality of life of patients with CAT.
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Affiliation(s)
- M Sebuhyan
- Groupe francophone thrombose et cancer, Paris, France; Department of Clinical Physiology, Lariboisière Hospital, AP-HP, Paris, France.
| | - B Crichi
- Groupe francophone thrombose et cancer, Paris, France; Department of Internal Medicine (UF 04), CRMR MATHEC, maladies auto-immunes et thérapie cellulaire, Saint-Louis Hospital, AP-HP, Paris, France
| | - L Deville
- Pharmacy Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - C Le Maignan
- Groupe francophone thrombose et cancer, Paris, France; Department of Internal Medicine (UF 04), CRMR MATHEC, maladies auto-immunes et thérapie cellulaire, Saint-Louis Hospital, AP-HP, Paris, France
| | - C Bonnet
- Department of Medical Oncology, Saint-Louis Hospital, AP-HP, Paris, France
| | - Z Marjanovic
- Groupe francophone thrombose et cancer, Paris, France; Department of Hematology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - J Rueda
- Groupe francophone thrombose et cancer, Paris, France; Department of Internal Medicine, Hospital Universitario Rey-Juan-Carlos, Madrid, Spain
| | - O Bensaoula
- Groupe francophone thrombose et cancer, Paris, France; Department of Medical Oncology CLCC Curie Institute, centre Rene-Huguenin, Saint Cloud, France
| | - A Ndour
- Groupe francophone thrombose et cancer, Paris, France; Department of Internal Medicine (UF 04), CRMR MATHEC, maladies auto-immunes et thérapie cellulaire, Saint-Louis Hospital, AP-HP, Paris, France
| | - C Frere
- Groupe francophone thrombose et cancer, Paris, France; Inserm UMRS_1166, Department of Hematology, Institute of Cardiometabolism And Nutrition, GRC 27 GRECO, Pitié-Salpêtrière Hospital, Sorbonne université, AP-HP, Paris, France
| | - I Madeleine
- Pharmacy Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - D Farge
- Groupe francophone thrombose et cancer, Paris, France; Department of Internal Medicine (UF 04), CRMR MATHEC, maladies auto-immunes et thérapie cellulaire, Saint-Louis Hospital, AP-HP, Paris, France; EA 3518, institut universitaire d'hématologie, université de Paris, Paris, France.
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Rafii H, Frère C, Benzidia I, Crichi B, Andre T, Assenat E, Bournet B, Carpentier A, Connault J, Doucet L, Durant C, Emmerich J, Gris JC, Hij A, Le Hello C, Madelaine I, Messas E, Ndour A, Villiers S, Marjanovic Z, Ait Abdallah N, Yannoutsos A, Farge D. Management of cancer-related thrombosis in the era of direct oral anticoagulants: A comprehensive review of the 2019 ITAC-CME clinical practice guidelines. On behalf of the Groupe Francophone Thrombose et Cancer (GFTC). J Med Vasc 2020; 45:28-40. [PMID: 32057323 DOI: 10.1016/j.jdmv.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Venous thromboembolism (VTE) is a common disease complication in cancer patients and the second cause of death after cancer progression. VTE management and prophylaxis are critical in cancer patients, but effective therapy can be challenging because these patients are at higher risk of VTE recurrence and bleeding under anticoagulant treatment. Numerous published studies report inconsistent implementation of existing evidence-based clinical practice guidelines (CPG), including underutilization of thromboprophylaxis, and wide variability in clinical practice patterns across different countries and various practitioners. This review aims to summarize the 2019 ITAC-CME evidence-based CPGs for treatment and prophylaxis of cancer-related VTE, which include recommendations on the use of direct oral anticoagulants specifically in cancer patients. The guidelines underscore the gravity of developing VTE in cancer and recommend the best approaches for treating and preventing cancer-associated VTE, while minimizing unnecessary or over-treatment. Greater adherence to the 2019 ITAC guidelines could substantially decrease the burden of VTE and improve survival of cancer patients.
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Affiliation(s)
- H Rafii
- Eurocord, Équipe 3 EA3518, hôpital Saint-Louis, Université de Paris, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Frère
- Inserm UMRS_1166, Department of Haematology, hôpital Pitié-Salpêtrière, Université de Paris, Sorbonne Paris-Cité, AP-HP, Paris, France
| | - I Benzidia
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - B Crichi
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - T Andre
- Hôpital Saint-Antoine, AP-HP, Paris, France
| | - E Assenat
- Montpellier school of Medicine, Saint-Eloi University Hospital, Montpellier, France
| | - B Bournet
- Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | | | | | - L Doucet
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - A Hij
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - C Le Hello
- CHU Saint-Étienne, Saint-Étienne, France
| | | | - E Messas
- Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - A Ndour
- Hôpital Saint-Louis, AP-HP, Paris, France
| | - S Villiers
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | - N Ait Abdallah
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | | | - D Farge
- Internal Medicine (UF04), Équipe 3 EA 3518, Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, AP-HP, Sorbonne Paris-Cité, Paris, France; Department of Medicine, McGill University, Montreal, QC, Canada
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Roussel C, Dussiot M, Duez J, Marin M, Morel A, Ndour A, Kim CLV, Hermine O, Colin Y, Buffet P, Amireault P. Optimisation transfusionnelle : étude de la lésion de stockage par cytométrie morphologique (AMNIS°) et microsphiltration. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dieng Y, Ndour A, Gaye O, Diouf G, Dieng T, Soumare M, Seydi M, Bah IB, Faye O, Ndir O, Faye Niang MA, Diallo S. [Pneumocystosis in HIV infected patients presenting with acid-fast bacilli negative pneumopathy at the Central University Hospital at Dakar]. Dakar Med 2000; 44:28-31. [PMID: 10797982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Pneumocystosis is an opportunist parasitic disease which occurs currently at Europe and United States in HIV infected patients. In Africa, the disease is not current. Pneumocystosis has been detected in the Fann medical universitary center at Dakar from HIV infected patients with acido alcoholo resistant bacilli negative pneumopathy. Analysis of broncho alveolar liquid(BAL) of 29 patients after Giemsa and Blue of Toluidin O staining allowed isolating of two cases of pneumocystosis. A man and a woman were the patients. They were HIV1 positive with at X ray bilateral interstitial syndrome. The CD4 lymphocytes count of the one was lower than 200/mm3 and for the other it was higher than 200/mm3.
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Affiliation(s)
- Y Dieng
- Service de Parasitologie et Mycologie de la Faculté de Médecine, Pharmacie et d'Odonto-Stomatologie de l'Université Cheikh Anta Diop de Dakar, Sénégal
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