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Malignidades, mutaciones protrombóticas y el riesgo de trombosis venosa
Jeanet W Blom1, Carine J M Doggen, Susanne Osanto
1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
JAMA
|February 11, 2005
Resumen
Los pacientes con cáncer enfrentan un riesgo significativamente mayor de trombosis venosa, particularmente dentro de los meses posteriores al diagnóstico o con metástasis distantes. Las mutaciones genéticas como el Factor V Leiden elevan aún más este riesgo.
Área de la Ciencia:
- Oncología Oncología.
- Hematología Hematología.
- Genética La genética.
Sus antecedentes:
- La trombosis venosa es una complicación frecuente y grave para los pacientes con cáncer, que afecta su calidad de vida.
- La identificación de pacientes con cáncer con mayor riesgo de trombosis es crucial para el manejo proactivo.
Objetivo del estudio:
- Para evaluar el riesgo trombótico en pacientes con cáncer.
- Evaluar la influencia del sitio del tumor, la metástasis y las mutaciones protrombóticas en este riesgo.
Principales métodos:
- Un estudio de casos y controles (MEGA) en el que participaron 3220 pacientes con trombosis venosa y 2131 controles.
- Datos recopilados a través de cuestionarios y análisis de ADN para mutaciones del Factor V Leiden y la protrombina 20210A.
Principales resultados:
- Los pacientes con cáncer tenían un riesgo 7 veces mayor de trombosis venosa.
- Los cánceres hematológicos, pulmonares y gastrointestinales representaban los riesgos más altos.
- El riesgo fue sustancialmente mayor en los primeros meses posteriores al diagnóstico, con metástasis distantes y en portadores de mutaciones del Factor V Leiden o de la protrombina 20210A.
Conclusiones:
- Los pacientes con cáncer, especialmente aquellos diagnosticados recientemente o con metástasis, tienen un riesgo marcadamente elevado de trombosis venosa.
- Las mutaciones genéticas protrombóticas amplifican este riesgo, lo que subraya la necesidad de una evaluación de riesgos personalizada.
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