Kapteijn Maaike Y, Bakker Nina, Koekkoek Johan A F, Versteeg Henri H, Buijs Jeroen T
Division of Thrombosis and Hemostasis, Department of Medicine, Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Thromb Haemost. 2025 May;125(5):421-434. doi: 10.1055/s-0044-1789592. Epub 2024 Aug 21.
Patients with glioblastoma are among the cancer patients with the highest risk of developing venous thromboembolism (VTE). Long-term thromboprophylaxis is not generally prescribed because of the increased susceptibility of glioblastoma patients to intracranial hemorrhage. This review provides an overview of the current clinical standard for glioblastoma patients, as well as the molecular and genetic background which underlies the high incidence of VTE. The two main procoagulant proteins involved in glioblastoma-related VTE, podoplanin and tissue factor, are described, in addition to the genetic aberrations that can be linked to a hypercoagulable state in glioblastoma. Furthermore, possible novel biomarkers and future treatment strategies are discussed, along with the potential of sequencing approaches toward personalized risk prediction for VTE. A glioblastoma-specific VTE risk stratification model may help identifying those patients in which the increased risk of bleeding due to extended anticoagulation is outweighed by the decreased risk of VTE.
胶质母细胞瘤患者是发生静脉血栓栓塞（VTE）风险最高的癌症患者之一。由于胶质母细胞瘤患者发生颅内出血的易感性增加，一般不进行长期血栓预防。本综述概述了胶质母细胞瘤患者的当前临床标准，以及VTE高发的分子和遗传背景。除了与胶质母细胞瘤高凝状态相关的基因畸变外，还描述了与胶质母细胞瘤相关VTE有关的两种主要促凝蛋白，血小板反应蛋白和组织因子。此外，还讨论了可能的新型生物标志物和未来的治疗策略，以及测序方法对VTE个性化风险预测的潜力。胶质母细胞瘤特异性VTE风险分层模型可能有助于识别那些因延长抗凝治疗导致出血风险增加但被VTE风险降低所抵消的患者。
