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Implementation of international good clinical practice guidelines to improve care of patients with cancer-related venous thromboembolism
Rahaf Qari1, Corinne Frere2, Dominique Farge3, Hanadi El Ayoubi4
1 Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
2 Assistance Publique-Hôpitaux de Marseille, Hematology laboratory, La Timome University Hospital; Aix-Marseille University, INSERM UMRS 1076, VRCM, Marseille; Paris 7 -Diderot University, INSERM UMRS 960, Sorbonne Paris Cité, Paris, France
3 Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Internal, Medicine and Vascular Disease Unit; Paris 7 -Diderot University, INSERM U 796, Sorbonne Paris Cité, Paris, France
4 Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Groupe Francophone Thrombose et Cancer, Paris, France
Correspondence Address:
Dominique Farge
Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Internal Medicine and Vascular Disease Unit, 1 avenue Claude Vellefaux, 75010 Paris
France
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/joah.joah_32_17
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Over the past 20 years, venous thromboembolism (VTE) has become the second cause of death in cancer patients, where it accounts for increased morbidity, mortality, and health-care costs. Incidental VTE is increasingly diagnosed on systematic computed tomography scan evaluations, raising new questions in daily oncology practice. The exact mechanisms underlying the increase in cancer-related VTE are not fully understood. Risk factors include patient-related, cancer-related, and treatment-related parameters which vary for a single patient throughout cancer disease and which require repeated individual risk assessments. Cumulative results from studies in cancer patients with versus without VTE suggest that anticoagulation therapy prevents morbidity and may reduce mortality. However, despite the availability of effective and safe therapeutic options, VTE is often underrecognized and sub-optimally managed. Clinical practice guidelines addressing the management of VTE in cancer patients are heterogeneous and require adequate educational and active implementation strategies. This review, resulting from an extensive literature search, aims to summarize the recently published evidence-based guidelines for treatment and prophylaxis of cancer-related VTE, as well as the place of new oral anticoagulants in the treatment strategies. Adherence to guidelines could substantially decrease the burden of VTE and increase survival in cancer patients.
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