Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Canada.
Institute of Hematology, Davidoff Cancer Centre, Rabin Medical Centre, Petah Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Best Pract Res Clin Haematol. 2022 Mar;35(1):101353. doi: 10.1016/j.beha.2022.101353. Epub 2022 Jun 16.
Venous (VTE) and arterial (ATE) thromboemboli are a leading cause of morbidity and mortality in patients with cancer. Patients with hematological malignancies are at an exceptionally high risk of both VTE and ATE. This risk varies based on patient- and disease-specific risk factors and can be predicted using risk prediction models for some types of hematological malignancies. Treatment of VTE for patients with hematological malignancies is largely based on randomized control trials that predominately enrolled patients with solid tumors. However, treatment must be balanced with the risk of anticoagulant or antiplatelet therapy in this unique patient population that can have a competing risk of bleeding. In this review, we present the evidence that addresses the risk and prediction of VTE, ATE and bleeding in patients with hematological malignancies and considerations for treatment of these conditions.
静脉血栓栓塞症（VTE）和动脉血栓栓塞症（ATE）是癌症患者发病率和死亡率的主要原因。血液系统恶性肿瘤患者同时存在 VTE 和 ATE 的极高风险。这种风险基于患者和疾病的具体危险因素而有所不同，某些类型的血液系统恶性肿瘤可以使用风险预测模型进行预测。对于血液系统恶性肿瘤患者的 VTE 治疗主要基于随机对照试验，这些试验主要纳入了实体瘤患者。然而，在这个具有出血竞争风险的独特患者群体中，必须权衡抗凝或抗血小板治疗的风险。在本综述中，我们介绍了针对血液系统恶性肿瘤患者 VTE、ATE 和出血风险及预测的证据，并对这些情况的治疗进行了讨论。
