Cancer-associated thromboembolism: antithrombotic management of hospitalized patients

AbstractCancer increases risk for venous thromboembolism. Incident thrombocytopenia increases hemorrhagic risk. Hospitalized adults with a cancer diagnosis who received subcutaneous dalteparin in doses adjusted according to platelet count were retrospectively evaluated. Outcomes of interest included nadir platelet counts, transfusions, thromboembolism, and hemorrhage. During a 2-year period of observation, 1854 cancer patients received individualized inpatient treatment with dalteparin. Transfusion was required in 38 of 77 (49.4%) patients with nadir platelet counts  <  25 × 109 cells/L as compared with 16 of 75 (21.3%) patients whose nadir platelet counts were 25 –50 × 109 cells/L [risk ratio (RR) 2.31; 95% CI 1.42 to 3.78, p  <  0.001] and 45 of 1657 (2.7%) patients with platelet counts >  50 × 109 cells/L (RR  − 8.07; 95% CI − 4.79 to − 13.59, p <  0.001). Transfusions were administered primarily as supportive therapy. Among transfusion recipients, new or recurrent venous thromboembolism was documented in 2.6%, 0%, and 2.2% of patients with nadir platelet counts of <  25, 25–50, or >  50 × 109 cells/L, respectively (p  >  0.9 for all comparisons). Acute blood loss or major bleeding was documented in 10.5%, 12.5%, and 15.6% of patients with platelet counts of <  25, 25–50, or >  50 × 109 cells/L, respectively (p  >  0.9 for all comparisons). Among hospitali...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research