Should Ambulatory Patients with Cancer Receive Anticoagulation for VTE Prophylaxis During Systemic Chemotherapy?
Recommendations • Routine prophylaxis with an antithrombotic agent is not recommended. • Patients receiving thalidomide or lenalidomide with chemotherapy or dexamethasone are at high risk for thrombosis and warrant prophylaxis. Until such time as data are available from randomized clinical trials (RCTs), low-molecular-weight-heparin (LMWH) or adjusted-dose warfarin (international normalized ratio [INR] ~1.5) is recommended in myeloma patients receiving thalidomide plus chemotherapy or dexamethasone. This recommendation is based on extrapolation from studies of postoperative prophylaxis in orthopedic surgery and a trial of adjusted-dose warfarin in breast cancer. • RCTs evaluating antithrombotic agents are needed in patients with multiple myeloma receiving thalidomide or lenalidomide plus chemotherapy and/or dexamethasone. • Research identifying better markers of ambulatory patients with cancer most likely to develop VTE is urgently needed. Should Patients with Cancer Undergoing Surgery
Related Questions
- Why do cancer patients begin on a modified version of the Gerson Therapy after chemotherapy pre-treatment? Why is the clinic the preferred place to start the therapy in this situation?
- Should Ambulatory Patients with Cancer Receive Anticoagulation for VTE Prophylaxis During Systemic Chemotherapy?
- Should Patients with Cancer Undergoing Surgery Receive Perioperative VTE Prophylaxis?
