Risk assessment models for anticoagulant-associated bleeding in cancer-associated thrombosis are limited, as only 1 of 15 models (CAT-BLEED) was developed specifically for this patient population.
Systematic Review
Are currently available risk assessment models for anticoagulant-associated bleeding applicable and validated in patients with cancer-associated thrombosis?
There is a critical lack of validated risk assessment models for anticoagulant-associated bleeding specifically designed or validated for patients with cancer-associated thrombosis.
Patients with venous thromboembolism events (VTE) in the context of cancer should receive anticoagulants as long as the cancer is active. Therefore, a tailor-made anticoagulation strategy should rely on an individualized risk assessment model (RAM) of recurrent VTE and anticoagulant-associated bleeding. The aim of this review is to investigate the applicability of the currently available RAMs for anticoagulant-associated bleeding after VTE in the CAT population and to provide new insights on how we can succeed in developing a new anticoagulant-associated bleeding RAM for the current medical care of CAT patients. A systematic search for peer-reviewed publications was performed in PubMed. Studies, including systematic reviews, were eligible if they comprised patients with VTE and used a design for developing a prediction model, score, or other prognostic tools for anticoagulant-associated bleeding during anticoagulant treatment. Out of 15 RAMs, just the CAT-BLEED was developed for CAT patients and none of the presented RAMs developed for the VTE general population were externally validated in a population of CAT patients. The current review illustrates the limitations of the available RAMs for anticoagulant-associated bleeding in CAT patients. The development of a RAM for bleeding risk assessment in patients with CAT is warranted.
Poénou et al. (Tue,) conducted a systematic review in Cancer-associated thrombosis (CAT). Risk assessment models (RAMs) was evaluated. Risk assessment models for anticoagulant-associated bleeding in cancer-associated thrombosis are limited, as only 1 of 15 models (CAT-BLEED) was developed specifically for this patient population.