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Venous thromboembolism in patients with hematologic malignancy and thrombocytopenia
American journal of hematology, 2016-11, Vol.91 (11), p.E468-E472
Khanal, Nabin
Bociek, R. Gregory
Chen, Baojiang
Vose, Julie M.
Armitage, James O.
Bierman, Philip J.
Maness, Lori J.
Lunning, Matthew A.
Gundabolu, Krishna
Bhatt, Vijaya R.
2016
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Khanal, Nabin
Bociek, R. Gregory
Chen, Baojiang
Vose, Julie M.
Armitage, James O.
Bierman, Philip J.
Maness, Lori J.
Lunning, Matthew A.
Gundabolu, Krishna
Bhatt, Vijaya R.
Titel
Venous thromboembolism in patients with hematologic malignancy and thrombocytopenia
Ist Teil von
American journal of hematology, 2016-11, Vol.91 (11), p.E468-E472
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2016
Quelle
Wiley-Blackwell Journals
Beschreibungen/Notizen
The optimal management of hematologic malignancy‐associated venous thromboembolism (VTE) in patients with moderate‐to‐severe thrombocytopenia is unclear. This is a retrospective study of 128 adult patients with hematologic malignancies who were diagnosed with VTE. The outcome of patients with significant thrombocytopenia (≤50,000/µL) was compared with those without. Forty‐seven patients (36.7%) had a platelet count ≤50,000/µL during a period of time of perceived need for new or continued anticoagulation. The median nadir platelet count in those with significant thrombocytopenia was 10,000/µL (range 2,000–45,000/µL) versus 165,000/µL (50,000–429,000/µL) in those without (P < 0.001). The median duration of significant thrombocytopenia in the first group was 10 days (1–35 days). Therapy during the period of significant thrombocytopenia included prophylactic‐dose low‐molecular‐weight heparin (LMWH) (47%), therapeutic‐dose LMWH or heparin (30%), warfarin (2%), inferior vena cava filter (2%), and observation (17%). Patients without thrombocytopenia were managed with the standard of care therapy. At a median follow‐up of more than 2 years, the risk of clinically significant bleeding (11% vs 6%, P = 0.22) including major bleeding (6% vs 2%) and clot progression or recurrence (21% vs 22%, P = 1.00) were similar in patients with or without significant thrombocytopenia. In a multivariate analysis, the risk of recurrence/progression (hazard ratio, HR 0.59, 95% CI 0.21–1.66, P = 0.31) and hemorrhage rate (HR 0.29, 95% CI 0.05–1.56, P = 0.15) did not differ based on the presence of significant thrombocytopenia. Within the limits of this retrospective study, cautious use of prophylactic‐dose LMWH may be safe in thrombocytopenic patients with hematologic malignancy‐associated VTE. Am. J. Hematol. 91:E468–E472, 2016. © 2016 Wiley Periodicals, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 0361-8609
eISSN: 1096-8652
DOI: 10.1002/ajh.24526
Titel-ID: cdi_proquest_miscellaneous_1826743582
Format
–
Schlagworte
Adolescent
,
Adult
,
Aged
,
Aged, 80 and over
,
Anticoagulants - therapeutic use
,
Female
,
Health risk assessment
,
Hematologic Neoplasms - complications
,
Hemorrhage - chemically induced
,
Heparin - therapeutic use
,
Heparin, Low-Molecular-Weight - therapeutic use
,
Humans
,
Male
,
Middle Aged
,
Multivariate analysis
,
Platelet Count
,
Premedication
,
Recurrence
,
Retrospective Studies
,
Thrombocytopenia - drug therapy
,
Thrombocytopenia - etiology
,
Thrombocytopenia - pathology
,
Thromboembolism
,
Venous Thromboembolism - etiology
,
Venous Thromboembolism - pathology
,
Warfarin - therapeutic use
,
Young Adult
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