High Rates of Thromboembolic Events in Patients with Germ Cell Cancer Undergoing Cisplatin-Based Polychemotherapy

Area of Science:

• Oncology
• Hematology
• Pharmacology

Background:

• Cisplatin-based chemotherapy for germ cell cancer poses a risk of thromboembolic events (TEEs).
• Low molecular weight heparin (LMWH) is used for prophylaxis, but the optimal duration is debated.

Purpose of the Study:

• To investigate if extended LMWH prophylaxis reduces TEE rates in germ cell cancer patients undergoing chemotherapy.
• To compare TEE incidence between extended and limited LMWH prophylaxis regimens.

Main Methods:

• Retrospective analysis of 93 germ cell cancer patients between January 2008 and December 2013.
• Patients received either extended (during chemotherapy plus 21 days post-chemotherapy) or limited (hospitalization only) LMWH prophylaxis.
• Thromboembolic events (deep vein thrombosis, pulmonary embolism, myocardial infarction, peripheral arterial thrombosis) were recorded.

Main Results:

• A total of 23.7% of patients experienced 30 TEEs.
• The incidence of TEEs was 26.7% in the extended prophylaxis group and 20.8% in the limited prophylaxis group.
• This difference in TEE rates between the two prophylaxis groups was not statistically significant.

Conclusions:

• Extended LMWH prophylaxis did not significantly decrease TEE rates in this cohort of germ cell cancer patients.
• Current prophylaxis strategies may require re-evaluation for this patient population.
• Further research is needed to optimize TEE prevention in cancer patients undergoing chemotherapy.