Lim Ming Sheng, Enjeti Anoop K
Haematology Department, Calvary Mater Hospital, Edith St, Waratah, NSW 2298, Australia.
Haematology Department, Calvary Mater Hospital, Edith St, Waratah, NSW 2298, Australia; University of Newcastle, Australia; Pathology North Hunter, NSW Pathology, Australia; Hunter Cancer Research Alliance, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia.
Crit Rev Oncol Hematol. 2016 Sep;105:92-9. doi: 10.1016/j.critrevonc.2016.06.011. Epub 2016 Jun 26.
Venous thromboembolism (VTE) is relatively common among patients with haematological malignancies. Management is challenging because many of these patients are also thrombocytopenic and at increased risk of bleeding. Current recommendations regarding the treatment of VTE in thrombocytopenic patients with haematological malignancies are limited as there only few studies evaluating the safety and efficacy of anticoagulation in this population of patient. A literature review on the safety of antithrombotic therapy for treatment or prophylaxis of VTE in patients with haematological malignancies was undertaken. This includes a report on 5 patients with haematological malignancies at our institute who received enoxaparin for treatment of VTE while thrombocytopenic. Unlike previous case series which showed that the use of LMWH (low molecular weight heparin) is safe in this group of patients, major bleeding occurred in 2 patients, and was fatal in one case. More studies are required to evaluate the risk factors and safety of anticoagulation in these patients.
静脉血栓栓塞症（VTE）在血液系统恶性肿瘤患者中相对常见。由于这些患者中有许多人也存在血小板减少症且出血风险增加，因此管理具有挑战性。目前关于血液系统恶性肿瘤血小板减少患者VTE治疗的建议有限，因为仅有少数研究评估了该患者群体中抗凝治疗的安全性和有效性。我们对血液系统恶性肿瘤患者治疗或预防VTE的抗血栓治疗安全性进行了文献综述。这包括我们研究所5例血液系统恶性肿瘤患者的报告，这些患者在血小板减少时接受依诺肝素治疗VTE。与之前显示低分子量肝素（LMWH）在该组患者中使用安全的病例系列不同，2例患者发生了大出血，其中1例死亡。需要更多研究来评估这些患者抗凝治疗的危险因素和安全性。
