Hematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161, Rome, Italy.
J Thromb Thrombolysis. 2022 Nov;54(4):625-629. doi: 10.1007/s11239-022-02702-9. Epub 2022 Sep 20.
Atrial fibrillation (AF) is common in patients with cancer due to both the proinflammatory effect of neoplastic cells and to cardiotoxicity of anti-tumor therapies. Anticoagulation is still challenging in cancer patients due to increased bleeding risk related to specific neoplasms such us hematologic malignancies. The aim of this retrospective study was to evaluate the safety and the efficacy of direct oral anticoagulants (DOACs) in AF patients affected by hematologic neoplasms. We included 97 patients on active anticancer treatment. The median follow-up was 25 months (range 10-108). No thromboembolic complications occurred, while 14 bleeding events were recorded: 1 major, 12 clinical relevant non major bleeding and 1 minor bleeding. Although retrospective and with a small number of enrolled patients, our data support the efficacy and safety of DOACs in patients affected by hematologic malignancies suggesting caution to particular situations, such as thrombocytopenia.
心房颤动（AF）在癌症患者中很常见，这既与肿瘤细胞的促炎作用有关，也与抗肿瘤治疗的心脏毒性有关。由于特定肿瘤（如血液恶性肿瘤）相关的出血风险增加，癌症患者的抗凝治疗仍然具有挑战性。本回顾性研究的目的是评估直接口服抗凝剂（DOAC）在患有血液系统恶性肿瘤的 AF 患者中的安全性和疗效。我们纳入了 97 名正在接受积极抗癌治疗的患者。中位随访时间为 25 个月（范围 10-108）。未发生血栓栓塞并发症，记录到 14 例出血事件：1 例主要出血，12 例临床相关非重大出血和 1 例轻微出血。尽管我们的数据是回顾性的，且纳入的患者数量较少，但支持 DOAC 在血液恶性肿瘤患者中的疗效和安全性，提示在某些特殊情况下（如血小板减少症）需要谨慎。
