Interní Med. 2011; 13(1): 13-17

The treatment of venous thromboembolism in cancer patients

MUDr.Jana Hirmerová, Ph.D.

II. interní klinika LF UK a FN Plzeň

Venous thromboembolism (VTE) represents a significant cause of morbidity and mortality in cancer patients. Basic principles of VTE treatment,

consisting mainly of anticoagulation, remain the same; however, this group of patients has specific risks. For the initial treatment, low

molecular weight heparin (LMWH) or unfractionated heparin is used. Warfarin is routinely used for long term treatment in patients without

cancer but in patients with cancer, this therapy is associated with significantly higher risk of major bleeding as well as that of VTE recurrence.

Taken together, the results from clinical trials in cancer patients with VTE confirm better efficacy of long term LMWH in reducing the risk of

VTE recurrence, compared to warfarin, and nonsignificant difference in bleeding complications between these two therapies. Therefore,

most of the international guideline panels recommend the use of LMWH for the initial, as well as for long term treatment of VTE in cancer

patients. In the first month, full anticoagulation dose is recommended with subsequent reduction of the dose to 75–80 %. The treatment

with LMWH should last at least 3–6 months or longer – until cancer is resolved and until anticancer therapy is finished.

Keywords: venous thromboembolism, cancer, anticoagulation, low molecular weight heparin

Published: January 14, 2011  Show citation