Benzidia Ilham, Crichi Benjamin, Montlahuc Claire, Rafii Hanadi, N'Dour Arlette, Sebuhyan Maxime, Gauthier Hélène, Ait Abdallah Nassim, Benillouche Philippe, Villiers Stéphane, Le Maignan Christine, Farge Dominique
Internal Medicine: Autoimmune and Vascular Disease Unit (UF04), Saint-Louis Hospital, Assistance Publique Hôpitaux de Paris, 1 Avenue Claude Vellefaux, 75010, Paris, France.
Clinical Research Unit Lariboisière Saint-Louis Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
J Thromb Thrombolysis. 2022 Feb;53(2):417-424. doi: 10.1007/s11239-021-02512-5. Epub 2021 Jul 22.
Treatment of Venous thromboembolism (VTE) in cancer patients is challenging due to higher risk of VTE recurrence or bleeding under anticoagulants. We assessed the effectiveness of a dedicated "Allo-Thrombosis Cancer" multidisciplinary care program (AlloTC-MCP) that incorporated individualized care, regular follow-ups, telephone counselling, and a patient education program.
From September 2017 to October 2019, 100 consecutive cancer patients with new VTE onset were enrolled in this observational single-center prospective pilot study and received standard (control group, n = first 50 patients enrolled) or AlloTC-MCP care (n = next 50 patients enrolled) over a 6-month VTE treatment follow-up period. Primary end-point was the percentage of adherence to the International Clinical Practice Guidelines (ITAC-CPGs) at 6 (M6) month follow-up.
Among the 100 patients with different cancer types (22% genitourinary, 19% breast, 16% gastrointestinal, 15% lymphoma, 11% lung and 17% others), 51 patients (61%) had metastatic disease and 31 (31%) received chemotherapy alone. Main baseline cancer and VTE clinical characteristics did not differ between the 2 groups. Adherence rates to ITAC-CPGs was significantly higher in the AlloTC-MCP group (100% (M0), 72% (M3) and 68% (M6)) compared with the control group (84% (M0), 8% (M3) and 16% (M6)). Quality of Life (QoL) was significantly improved in the AlloTC-MCP group 6 months after inclusion.
The "AlloTC-MCP" was associated with improved adherence to ITAC-CPGs and merits further expansion.
由于癌症患者静脉血栓栓塞（VTE）复发风险较高或在抗凝治疗下有出血风险，因此对其进行治疗具有挑战性。我们评估了一个专门的“同种异体血栓形成癌症”多学科护理计划（AlloTC-MCP）的有效性，该计划纳入了个性化护理、定期随访、电话咨询和患者教育计划。
从2017年9月至2019年10月，100例连续新发VTE的癌症患者被纳入这项观察性单中心前瞻性试点研究，并在6个月的VTE治疗随访期内接受标准治疗（对照组，n =首批入组的50例患者）或AlloTC-MCP护理（n =接下来入组的50例患者）。主要终点是在6个月（M6）随访时遵循国际临床实践指南（ITAC-CPGs）的百分比。
在100例患有不同癌症类型的患者中（22%为泌尿生殖系统癌症，19%为乳腺癌，16%为胃肠道癌症，15%为淋巴瘤，11%为肺癌，17%为其他癌症），51例患者（61%）患有转移性疾病，31例（31%）仅接受化疗。两组之间主要的基线癌症和VTE临床特征无差异。与对照组（M0时84%，M3时8%，M6时16%）相比，AlloTC-MCP组对ITAC-CPGs的遵循率显著更高（M0时100%，M3时72%，M6时68%）。纳入后6个月，AlloTC-MCP组的生活质量（QoL）显著改善。
“AlloTC-MCP”与提高对ITAC-CPGs的遵循率相关，值得进一步推广。
