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Evidence-based guidance on venous thromboembolism in patients with solid tumours
M A Shea-Budgell1, C M J Wu2, J C Easaw3
1Guideline Utilization Resource Unit, Cancer-Control Alberta, Alberta Health Services, Calgary, AB.
Current Oncology (Toronto, Ont.)
|June 19, 2014
Summary
Low molecular weight heparin (LMWH) is recommended for managing venous thromboembolism (VTE) in cancer patients with solid tumors. This guideline provides evidence-based strategies for VTE prevention and treatment in this complex patient population.
Area of Science:
- Oncology
- Hematology
- Clinical Guidelines
Background:
- Venous thromboembolism (VTE) is a significant life-threatening complication in cancer patients.
- Managing VTE in cancer patients is complex due to ongoing cancer therapies.
- No specific Canadian guidelines exist for VTE management in solid tumors.
Purpose of the Study:
- To develop a clear, evidence-based guideline for VTE management in patients with solid tumors.
- To provide Canadian clinicians with strategies for VTE prevention and treatment in this population.
Main Methods:
- Systematic review of clinical trials and meta-analyses (2002-2013) from PubMed.
- Hand-searched reference lists and searched the National Guidelines Clearinghouse.
- Recommendations developed based on the best available evidence.
Main Results:
- Low molecular weight heparin (LMWH) is recommended for established VTE and high-risk VTE in solid tumor patients.
- LMWH options include dalteparin, enoxaparin, and tinzaparin; tinzaparin preferred in renal insufficiency.
- Unfractionated heparin is reserved for specific situations requiring rapid anticoagulant clearance.
Conclusions:
- LMWH is the preferred anticoagulant for VTE management in solid tumor patients.
- Bleeding is the most common adverse event, but major events are rare with monitoring.
- This guideline offers crucial evidence-based recommendations for Canadian clinicians.
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