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Blood, 15 December 2005, Vol. 106, No. 13, pp. 4027-4033. Prepublished online as a Blood First Edition Paper on August 2, 2005; DOI 10.1182/blood-2005-04-1508. This Article Full Text (PDF) All Versions of this Article: 2005-04-1508v1 106/13/4027    most recent Alert me when this article is cited Alert me if a correction is posted 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. Search for Related Content PubMed PubMed Citation Articles by Prandoni, P. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted April 13, 2005 Accepted July 24, 2005 How I treat venous thromboembolism in patients with cancer Paolo Prandoni* Department of Medical and Surgical Sciences, 2nd Chair of Internal Medicine, University of Padua, Padua, Italy * Corresponding author; email: paoloprandoni{at}tin.it. Venous thromboembolism (VTE) is a frequent complication in cancer patients, and represents an important cause of morbidity and mortality. Especially in those patients who have a poor life expectancy, preventing death from pulmonary embolism is the mainstay of treatment. Critically ill patients should promptly be administered thrombolytic drugs. Except for selected patients requiring aggressive therapy, the initial VTE treatment should be conducted with either adjusted-dose unfractionated heparin or fixed-dose low-molecular-weight heparin (LMWH). LMWHs have the potential to greatly simplify the initial treatment of VTE, making the treatment of suitable patients feasible in an outpatient setting. During anticoagulant therapy, cancer patients have a two- to four-fold higher risk of recurrent VTE and major bleeding complications when compared to non-cancer patients. The long-term administration of LMWH should be considered as an alternative to anti-vitamin K drugs in patients with advanced disease and in those with conditions limiting the use of oral anticoagulants. Prolongation of anticoagulation should be considered for as long as the malignant disorder is active. The evidence of lowered cancer mortality in patients on LMWH has stimulated renewed interest in these agents as antineoplastic drugs, and raises the distinct possibility that cancer and thrombosis share common mechanisms. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: D. Imberti, G. Agnelli, W. Ageno, M. Moia, G. Palareti, R. Pistelli, R. Rossi, M. Verso, and for the MASTER Investigators Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry Haematologica, February 1, 2008; 93(2): 273 - 278. [Abstract] [Full Text] [PDF]

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