Low-molecular-weight heparins are as safe and effective as standard heparin for acute deep vein thrombosis in cancer patients, and may be associated with lower mortality rates.
Does low-molecular-weight heparin reduce mortality and improve safety compared to standard heparin in cancer patients with thrombotic disorders?
LMWHs are an effective and safe alternative to standard heparin for treating venous thromboembolism in cancer patients, potentially offering a mortality benefit due to an inhibitory effect on tumor growth.
Cancer patients are in a hypercoagulable state. The pathogenesis of thrombosis in malignancy is multifactorial with mechanisms including release of procoagulants by tumour cells, comorbid predisposing factors (bed rest, infection, surgery, etc.) and anti-cancer drugs. Cancer patients with established venous thromboembolism are more likely to develop recurrent venous thromboembolism during treatment with oral anticoagulants. This paper reviews the use of heparin for the treatment of thrombotic disorders in cancer patients. Treatment of acute venous thrombosis comprises initial heparin administration, which for a cancer patient should last for at least 5 days, followed by administration of oral anticoagulants. Low-molecular-weight heparins (LMWHs) have been shown to be as safe and effective as standard heparin for the treatment of acute deep vein thrombosis. Recent meta-analyses have revealed lower mortality rates with LMWH than with standard heparin, indicating that LMWH may exert an inhibitory effect on tumour growth that is not observed with standard heparin.
MN Levine (Tue,) conducted a review in Thrombotic disorders in cancer patients. Low-molecular-weight heparins (LMWHs) vs. Standard heparin was evaluated on Mortality rates and treatment of acute deep vein thrombosis. Low-molecular-weight heparins are as safe and effective as standard heparin for acute deep vein thrombosis in cancer patients, and may be associated with lower mortality rates.