Autoimmune and Vascular Disease Unit, Internal Medicine (UF04), Center of Reference for Rare Systemic Autoimmune Diseases (FAI2R), Université de Paris, Paris, France; Department of Medicine, McGill University, Montreal, QC, Canada.
Department of Haematology, Sorbonne Université, UMRS 1166, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.
Lancet Oncol. 2019 Oct;20(10):e566-e581. doi: 10.1016/S1470-2045(19)30336-5. Epub 2019 Sep 3.
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at a high risk of VTE recurrence and bleeding during anticoagulant therapy. The International Initiative on Thrombosis and Cancer is an independent academic working group aimed at establishing a global consensus for the treatment and prophylaxis of VTE in patients with cancer. The International Initiative on Thrombosis and Cancer last updated its evidence-based clinical practice guidelines in 2016 with a free, web-based mobile phone application, which was subsequently endorsed by the International Society on Thrombosis and Haemostasis. The 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines, which are based on a systematic review of the literature published up to December, 2018, are presented along with a Grading of Recommendations Assessment Development and Evaluation scale methods, with the support of the French National Cancer Institute. These guidelines were reviewed by an expanded international advisory committee and endorsed by the International Society on Thrombosis and Haemostasis. Results from head-to-head clinical trials that compared direct oral anticoagulant with low-molecular-weight heparin are also summarised, along with new evidence for the treatment and prophylaxis of VTE in patients with cancer.
静脉血栓栓塞症(VTE)是癌症患者的第二大死亡原因。这些患者在抗凝治疗期间有发生 VTE 复发和出血的高风险。国际血栓与癌症倡议是一个独立的学术工作组,旨在为癌症患者的 VTE 治疗和预防建立全球共识。国际血栓与癌症倡议于 2016 年最后一次更新了其基于证据的临床实践指南,同时还发布了一个免费的、基于网络的手机应用程序,随后得到了国际血栓与止血学会的认可。这些指南是基于截至 2018 年 12 月发表的文献的系统回顾制定的,并附有推荐评估、制定与评估分级方法,得到了法国国家癌症研究所的支持。这些指南由一个扩大的国际咨询委员会进行了审查,并得到了国际血栓与止血学会的认可。还总结了直接口服抗凝剂与低分子量肝素头对头临床试验的结果,以及癌症患者 VTE 治疗和预防的新证据。