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Thrombosis and hemostatic abnormalities in hematological malignancies
Riccardo Colombo1, Paolo Gallipoli2, Roberto Castelli1
1Department of Pathophysiology and Transplantation, Internal Medicine Section, University of Milan, and Department of Haematology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
Clinical Lymphoma, Myeloma & Leukemia
|July 15, 2014
Summary
Patients with hematological malignancies face a high risk of thrombosis, especially during diagnosis and chemotherapy. Identifying high-risk individuals is crucial for targeted thromboprophylaxis to prevent bleeding complications.
Area of Science:
- Hematology
- Oncology
- Thrombosis Research
Background:
- Limited data exists on thrombosis in hematological malignancies.
- Lymphoma, multiple myeloma, and acute leukemia patients show increased thrombotic risk, particularly at diagnosis and during chemotherapy.
Purpose of the Study:
- To review thromboembolic complications in patients with hematological malignancies.
- To understand the multifactorial pathogenesis of thrombosis in these patients.
- To highlight the challenges in anticoagulant therapy due to hemorrhage risk.
Main Methods:
- PubMed database search for relevant articles.
- Inclusion of studies published between 1996 and 2013.
- Review of factors influencing thrombotic event incidence and pathogenesis.
Main Results:
- Thrombotic event incidence varies based on malignancy type, stage, therapy, and central venous device use.
- Multifactorial pathogenesis involves tumor factors, inflammatory cytokines, chemotherapy, immunomodulatory drugs, and infections.
- Plasma cell dyscrasias present unique risks including hyperviscosity and acquired activated protein C resistance.
Conclusions:
- Accurate thrombotic risk assessment is essential for effective thromboprophylaxis in high-risk patients.
- Managing thrombosis in hematological malignancies is complex due to high hemorrhage risk with anticoagulant therapy.
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