Individualized anticoagulant therapy in cancer patients with venous thromboembolism and thrombocytopenia is required based on thrombocytopenia severity, expected duration, and thrombotic risk.
The management of VTE in cancer patients with severe thrombocytopenia requires an individualized approach balancing the risk of fatal pulmonary embolism or VTE progression against the risk of major bleeding.
Cancer and its treatment predispose to thromboembolic complications and thrombocytopenia. Thrombocytopenia does not protect against thromboembolism, but increases the risk of bleeding. The prognosis in venous thromboembolism (VTE) strictly depends on the efficacy of anticoagulation. The choice of anticoagulation strategy will depend on the severity of thrombocytopenia and its expected duration. Thrombotic risk is also important, determining the risk of death related to pulmonary embolism and the risk of recurrence/progression of VTE. Possible strategies include full anticoagulation and possible platelet transfusions, modification of the anticoagulation dose or interruption of anticoagulation. The review focuses on the possibilities of VTE treatment in the aspect of clinically significant thrombocytopenia with a platelet count below 50 × 109/L (50 000/µl).
Szmit et al. (Thu,) conducted a review in Cancer-associated venous thromboembolism with thrombocytopenia. Anticoagulant therapy (full dose, modified dose, or interruption) was evaluated. Individualized anticoagulant therapy in cancer patients with venous thromboembolism and thrombocytopenia is required based on thrombocytopenia severity, expected duration, and thrombotic risk.