[The disorders of hemostasis and their prevention with low-molecular heparins in oncological patients]

The patients with malignant neoplasms are subjected to high risk of development of venous and arterial thromboembolic disease. The development of thrombosis complicates treatment and deteriorates indicators of survival. The alterations in the system of hemostasis brought on by both tumor and methods of treatment play the main role in pathogenesis of thrombotic complications in oncological patients. The application of low-molecular heparins (Klexan and Fraxiparine) prior to operation and during post-operative period decreases activation of pro-coagulant (prolongation of activated partial thromboplastin time, pro-prothrombin activity and concentration of fibrinogen) and platelet-derived components of system of hemostasis, level of markers of intravascular coagulation of blood, von Willebrand factor. The low-molecular heparins favor preservation of natural inhibitors of thrombin and support protective function of fibrinolytic system. In the group of patients with tumors of locomotor apparatus receiving no pharmaceutical prevention thrombotic complications developed in 13% of cases and in the group of patients receiving Klexan complications developed in 2% of cases. In the group of patients with oncological gynecological patients receiving no pharmaceutical prevention thrombotic complications developed in 13% of cases and in the group of these patients receiving Fraxiparine thrombotic complications developed in 6% of cases and in the group of patients receiving Klexan thrombotic complications developed in 5% of cases. In oncological patients during the period of anti-tumor treatment the intensity of intravascular coagulation of blood is increased. The application of low-molecular heparins against the background of antitumor therapy decreases activation of intravascular coagulation of blood and rate of thrombotic complications. In the group of patients receiving no pharmaceutical prevention the thrombotic complications developed in 21% of patients and in the group of patients receiving low-molecular heparins the complications developed in 4% of patients.