[Which anticoagulant or antiplatelet treatment for cancer patients with thrombocytopenia ?]

Cancer patients have an increased thrombotic risk of arterial and venous thrombosis. Thrombocytopenia, particularly with anticoagulation, exposes the patient to an increased risk of bleeding but does not reduce the risk of recurrent thrombosis. When platelets are < 50 × 109/l, the strategy regarding anticoagulation must be reassessed. Based on the thrombotic and bleeding risks as well as the expected duration of thrombocytopenia, management options include full-dose treatment with platelet transfusion, reduced-dose anticoagulation or withholding antithrombotic therapy. Aspirin treatment appears to be a reasonable choice for thrombocytopenic (> 30 × 109/l) patients with acute coronary syndrome. This paper will review the guidelines on anticoagulation and antiplatelet therapy in thrombocytopenic cancer patients.