Piccioli Andrea, Vianello Fabrizio, Prandoni Paolo
University of Padova, Via Ospedale Civile 105, Padova 35128, Italy.
Curr Hematol Rep. 2002 Sep;1(1):79-83.
The management of thrombosis in patients with cancer is a clinical challenge. Although the prevalence of thromboembolic complications in hematologic malignancies is lower than that reported for solid tumors, thrombotic events are increasingly being reported both in patients with acute leukemia and in those with chronic myeloproliferative and lymphoproliferative disorders. Accordingly, there is the need for promptly identifying patients at a higher risk of developing thromboembolic complications, as well as instituting appropriate measures of prophylaxis and treatment. We briefly summarize the pathogenetic evidence for the existence of a prothrombotic state in patients with hematologic malignancies, discuss common clinical pictures, and examine those modalities of prophylaxis and treatment that are commonly recommended in this clinical setting. Further work is needed to provide physicians with specific guidelines for a systematic management of thrombosis in patients with hematologic malignancies.
癌症患者血栓形成的管理是一项临床挑战。尽管血液系统恶性肿瘤中血栓栓塞并发症的发生率低于实体瘤的报告发生率,但急性白血病患者以及慢性骨髓增殖性和淋巴增殖性疾病患者中血栓形成事件的报告越来越多。因此,需要及时识别发生血栓栓塞并发症风险较高的患者,并采取适当的预防和治疗措施。我们简要总结血液系统恶性肿瘤患者存在血栓前状态的发病机制证据,讨论常见的临床表现,并研究在这种临床情况下通常推荐的预防和治疗方式。需要进一步开展工作,为医生提供针对血液系统恶性肿瘤患者血栓形成进行系统管理的具体指南。