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Prepublished online as a Blood First Edition Paper on July 12, 2002; DOI 10.1182/blood-2002-01-0108. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-01-0108v1 100/10/3484    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Prandoni, P. Articles by Girolami, A. Search for Related Content PubMed PubMed Citation Articles by Prandoni, P. Articles by Girolami, A. Related Collections Hemostasis, Thrombosis, and Vascular Biology Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 November 2002, Vol. 100, No. 10, pp. 3484-3488 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis Paolo Prandoni, Anthonie W. A. Lensing, Andrea Piccioli, Enrico Bernardi, Paolo Simioni, Bruno Girolami, Antonio Marchiori, Paola Sabbion, Martin H. Prins, Franco Noventa, and Antonio Girolami From the Department of Medical and Surgical Sciences, Second Chair of Internal Medicine, and the Department of Clinical and Experimental Medicine, Clinical Epidemiology Group, Fifth Chair of Internal Medicine, University Hospital of Padua, Italy; and Center for Vascular Medicine and the Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam, The Netherlands. A small proportion of patients with deep vein thrombosis develop recurrent venous thromboembolic complications or bleeding during anticoagulant treatment. These complications may occur more frequently if these patients have concomitant cancer. This prospective follow-up study sought to determine whether in thrombosis patients those with cancer have a higher risk for recurrent venous thromboembolism or bleeding during anticoagulant treatment than those without cancer. Of the 842 included patients, 181 had known cancer at entry. The 12-month cumulative incidence of recurrent thromboembolism in cancer patients was 20.7% (95% CI, 15.6%-25.8%) versus 6.8% (95% CI, 3.9%- 9.7%) in patients without cancer, for a hazard ratio of 3.2 (95% CI, 1.9-5.4) The 12-month cumulative incidence of major bleeding was 12.4% (95% CI, 6.5%-18.2%) in patients with cancer and 4.9% (95% CI, 2.5%-7.4%) in patients without cancer, for a hazard ratio of 2.2 (95% CI, 1.2-4.1). Recurrence and bleeding were both related to cancer severity and occurred predominantly during the first month of anticoagulant therapy but could not be explained by sub- or overanticoagulation. Cancer patients with venous thrombosis are more likely to develop recurrent thromboembolic complications and major bleeding during anticoagulant treatment than those without malignancy. These risks correlate with the extent of cancer. Possibilities for improvement using the current paradigms of anticoagulation seem limited and new treatment strategies should be developed. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: D. O. Claassen, N. Kazemi, A. Y. Zubkov, E. F. M. Wijdicks, and A. A. Rabinstein Restarting Anticoagulation Therapy After Warfarin-Associated Intracerebral Hemorrhage Arch Neurol, October 1, 2008; 65(10): 1313 - 1318. [Abstract] [Full Text] [PDF] M. Carrier, G. Le Gal, P. S. Wells, D. Fergusson, T. Ramsay, and M. A. Rodger Systematic Review: The Trousseau Syndrome Revisited: Should We Screen Extensively for Cancer in Patients with Venous Thromboembolism? Ann Intern Med, September 2, 2008; 149(5): 323 - 333. [Abstract] [Full Text] [PDF] S. Schulman, R. J. Beyth, C. Kearon, and M. N. 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