Use of low-molecular-weight heparins in the treatment and secondary prevention of cancer-associated thrombosis.

OBJECTIVE

To provide oncology nurses with an understanding of the differences between low-molecular-weight heparins and unfractionated heparin, key clinical trial data, and current treatment guidelines.

DATA SOURCES

Primary and tertiary literature and the authors' clinical experience.

CONCLUSION

The latest American College of Chest Physicians guidelines recommend low-molecular weight heparin for at least the first 3 to 6 months of long-term treatment for most patients with cancer and deep vein thrombosis (DVT; grade 1A).

IMPLICATIONS FOR NURSING PRACTICE

Anticoagulant therapy has been found to be the most effective form of treatment for venous thromboembolism in patients with cancer, and oncology nurses play a critical role in the choice of agents, the dispensing of drugs, and the monitoring of ongoing therapy. Vital to that role are an ability to differentiate among the available agents and apply the current practice guidelines based on the clinical trial data.