Thromboprophylaxis for medical patients with cancer: what do the guidelines say?

Venous thromboembolism (VTE) is frequent in cancer patients and is one of the leading causes of death in this population. Hospitalized cancer patients and those receiving chemotherapy are at the greatest risk of developing VTE. Many randomized controlled trials in a variety of patient populations have demonstrated that primary prophylaxis is effective in reducing the risk of VTE among cancer patients. Pharmacological thromboprophylaxis is recommended in all hospitalized medically ill cancer patients without a contraindication to anticoagulant therapy. Thromboprophylaxis in ambulatory patients undergoing chemotherapy is only considered in those at high risk of VTE. In this article, we evaluate the different clinical practice guideline recommendations for primary VTE prophylaxis in hospitalized medically ill patients with cancer and ambulatory patients undergoing chemotherapy.