Hematology and Stem Cell Transplantation Unit, University Campus Bio-Medico, Italy.
Hematology Unit, Reference Regional Center for Thrombosis and Haemostasis, University of Palermo, Italy.
Crit Rev Oncol Hematol. 2018 Apr;124:41-50. doi: 10.1016/j.critrevonc.2018.02.003. Epub 2018 Feb 8.
Venous Thromboembolism (VTE) frequently complicates the course of hematologic malignancies (HM) and its incidence is similar to that observed in high-risk solid tumors. Despite that, pharmacologic prophylaxis and treatment of VTE in patients with HM is challenging, mainly because a severe thrombocytopenia frequently complicates the course of treatments or may be present since diagnosis, thus increasing the risk of bleeding. Therefore, in this setting, safe and effective methods of VTE prophylaxis and treatment have not been well defined and hematologists generally refer to guidelines produced for cancer patients that give indications on anticoagulation in patients with thrombocytopenia. In this review, besides to summarize the incidence and the available data on prophylaxis and treatment of VTE in HM, we give some advices on how to use antithrombotic drugs in patients with HM according to platelets count.
静脉血栓栓塞症(VTE)常使血液系统恶性肿瘤(HM)的病程复杂化,其发生率与高危实体瘤相似。尽管如此,HM 患者的 VTE 药物预防和治疗仍然具有挑战性,主要是因为严重血小板减少症常使治疗复杂化,或者可能从诊断时就存在,从而增加出血风险。因此,在这种情况下,尚未明确 VTE 预防和治疗的安全有效的方法,血液科医生通常参考为癌症患者制定的指南,这些指南为血小板减少症患者的抗凝治疗提供了适应证。在本综述中,我们除了总结 HM 中 VTE 的发生率和现有预防及治疗数据外,还根据血小板计数就如何在 HM 患者中使用抗血栓药物提供了一些建议。