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Review of the Relationship Between Venous Thromboembolism, Malignancy and Its Treatment

Scott & White Memorial Hospital and Clinic, Department of Pharmacy, Temple, Texas

Jon D. Herrington, PharmD, BCPS, BCOP

Scott & White Memorial Hospital and Clinic, Department of Pharmacy, Temple, Texas, jherrington{at}swmail.sw.org, Texas A&M University HSC

Venous thromboembolism is a common complication that develops in approximately 20% of patients with cancer. Presence of tumor and other risk factors, such as inflammation, surgery, obesity, and medications, have the potential to alter the intravascular coagulation homeostasis and lead to thrombosis. Although malignancy may predispose patients to venous thromboembolism, many chemotherapy agents also increase the risk. In this article, some of the agents tamoxifen, asparaginase, fluorouracil, thalidomide, lenalidomide, bevacizumab, and hematopoietic growth factors are discussed. Many patients will experience a thrombotic event despite optimal prophylaxis. Thus, this article will address the guidelines for treatment and prophylaxis of venous thromboembolism. In general, the venous thromboembolism risk should be assessed before certain antineoplastic regimens are prescribed to patients with cancer.

Key Words: Venous thromboembolism • heparin • low— molecular weight heparin • warfarin • fondaparinux

Journal of Pharmacy Practice, Vol. 21, No. 2, 126-137 (2008)
DOI: 10.1177/0897190008315057


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