Venous thromboembolism in cancer – Cardiology MCQ

Which of the following cancer has the highest relative risk of venous thromboembolism? a) Pancreatic cancer b) Brain cancer c) Multiple myeloma d) Colonic cancer Correct answer: c) Multiple myeloma Multiple myeloma has forty six fold risk of venous thromboembolism than healthy controls while brain cancer has twenty fold and pancreatic cancer sixteen fold relative risk. But by absolute numbers, most episodes occur with lung, colon and prostate  cancer [1]. Chemotherapy confers six fold extra risk though chemotherapy per se is not considered an indication for prophylactic anticoagulation in ambulatory patients, the exception being multiple myeloma chemotherapy based on thalidomide or lenalidomide [2]. Reference Cronin-Fenton DP, Søndergaard F, Pedersen LA, Fryzek JP, Cetin K, Acquavella J, Baron JA, Sørensen HT. Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study in Denmark, 1997 -2006. Br J Cancer 2010;103(7):947 -953. Palumbo A et al. Aspirin, warfarin, or enoxaparin thromboprophylaxis in patients with multiple myeloma treated with thalidomide: a phase III, open-label, randomized trial. J Clin Oncol 2011;29(8):986-993. Akl EA, Vasireddi SR, Gunukula S, Yosuico VE, Barba M, Sperati F, Cook D, Schunemann H. Anticoagulation for patients with cancer and central venous catheters. Cochrane Database Syst Rev 2011;(4):CD006468. The post Venous thromboembolism in cancer – Cardiology MCQ appeared firs...
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