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Current Oncology
Volume 22
Issue 2
10.3747/co.22.2586
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Canadian Consensus Recommendations on the Management of Venous Thromboembolism in Patients with Cancer. Part 1: Prophylaxis

by
J.C. Easaw
1,*,
M.A. Shea–Budgell
1,
C.M.J. Wu
1,
P.M. Czaykowski
2,
J. Kassis
3,
B. Kuehl
4,
H.J. Lim
5,
M. MacNeil
6,
D. Martinusen
5,
P.A. McFarlane
4,
E. Meek
1,
O. Moodley
7,
S. Shivakumar
6,
V. Tagalakis
3,
S. Welch
4 and
P. Kavan
3,*
1
Alberta: Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Centre, Calgary (Easaw, Shea– Budgell); Cancer Strategic Clinical Network, Alberta Health Services, Calgary (Shea–Budgell); Division of Hematology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (Wu); Guideline Utilization Resource Unit, CancerControl Alberta, Alberta Health Services, Calgary (Meek)
2
Manitoba: Department of Medicine, University of Manitoba, Cancer Care Manitoba, Winnipeg (Czaykowski)
3
Quebec: Hôpital Maisonneuve–Rosemont, Montreal (Kassis); Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal (Tagalakis); Department of Oncology, Faculty of Medicine, McGill University, Montreal (Kavan)
4
Ontario: Scientific Insights Consulting Group, Mississauga (Kuehl); Department of Medicine, St. Michael’s Hospital Division of Nephrology, University of Toronto, Toronto (McFarlane); Department of Oncology, Western University, London (Welch)
5
British Columbia: Department of Medical Oncology, BC Cancer Agency, Vancouver (Lim); BC Provincial Renal Agency and Faculty of Pharmaceutical Sciences, University of British Columbia and Royal Jubilee Hospital, Victoria (Martinusen)
6
Nova Scotia: Department of Medicine, Dalhousie University, Halifax (MacNeil); Department of Medicine, Dalhousie University and Capital District Health Authority, Halifax (Shivakumar)
7
Saskatchewan: Department of Medicine, Division of Hematology, University of Saskatchewan, Saskatoon (Moodley)
*
Authors to whom correspondence should be addressed.
Curr. Oncol. 2015, 22(2), 133-143; https://doi.org/10.3747/co.22.2586
Submission received: 2 January 2015 / Revised: 11 February 2015 / Accepted: 9 March 2015 / Published: 1 April 2015

Abstract

Patients with cancer are at increased risk of venous thromboembolism (vte). Anticoagulation therapy has been shown to prevent vte; however, unique clinical circumstances in patients with cancer can often complicate the decisions surrounding the administration of prophylactic anticoagulation. No national Canadian guidelines on the prevention of cancer-associated thrombosis have been published. We therefore aimed to develop a consensus-based, evidence-informed guideline on the topic. PubMed was searched for clinical trials and meta-analyses published between 2002 and 2013. Reference lists of key articles were hand-searched for additional publications. Content experts from across Canada were assembled to review the evidence and make recommendations. Low molecular weight heparin can be used prophylactically in cancer patients at high risk of developing vte. Direct oral anticoagulants are not recommended for vte prophylaxis at this time. Specific clinical scenarios, including renal insufficiency, thrombocytopenia, liver disease, and obesity can warrant modifications in the administration of prophylactic anticoagulant therapy. There is no evidence to support the monitoring of anti–factor Xa levels in clinically stable cancer patients receiving prophylactic anticoagulation; however, factor Xa levels could be checked at baseline and periodically in patients with renal insufficiency. The use of anticoagulation therapy to prolong survival in cancer patients without the presence of risk factors for vte is not recommended.
Keywords: Low molecular weight heparin; prophylaxis; anticoagulation; venous thromboembolism; pulmonary embolism; deep vein thrombosis; clots; practice guideline Low molecular weight heparin; prophylaxis; anticoagulation; venous thromboembolism; pulmonary embolism; deep vein thrombosis; clots; practice guideline

Share and Cite

MDPI and ACS Style

Easaw, J.C.; Shea–Budgell, M.A.; Wu, C.M.J.; Czaykowski, P.M.; Kassis, J.; Kuehl, B.; Lim, H.J.; MacNeil, M.; Martinusen, D.; McFarlane, P.A.; et al. Canadian Consensus Recommendations on the Management of Venous Thromboembolism in Patients with Cancer. Part 1: Prophylaxis. Curr. Oncol. 2015, 22, 133-143. https://doi.org/10.3747/co.22.2586

AMA Style

Easaw JC, Shea–Budgell MA, Wu CMJ, Czaykowski PM, Kassis J, Kuehl B, Lim HJ, MacNeil M, Martinusen D, McFarlane PA, et al. Canadian Consensus Recommendations on the Management of Venous Thromboembolism in Patients with Cancer. Part 1: Prophylaxis. Current Oncology. 2015; 22(2):133-143. https://doi.org/10.3747/co.22.2586

Chicago/Turabian Style

Easaw, J.C., M.A. Shea–Budgell, C.M.J. Wu, P.M. Czaykowski, J. Kassis, B. Kuehl, H.J. Lim, M. MacNeil, D. Martinusen, P.A. McFarlane, and et al. 2015. "Canadian Consensus Recommendations on the Management of Venous Thromboembolism in Patients with Cancer. Part 1: Prophylaxis" Current Oncology 22, no. 2: 133-143. https://doi.org/10.3747/co.22.2586

APA Style

Easaw, J. C., Shea–Budgell, M. A., Wu, C. M. J., Czaykowski, P. M., Kassis, J., Kuehl, B., Lim, H. J., MacNeil, M., Martinusen, D., McFarlane, P. A., Meek, E., Moodley, O., Shivakumar, S., Tagalakis, V., Welch, S., & Kavan, P. (2015). Canadian Consensus Recommendations on the Management of Venous Thromboembolism in Patients with Cancer. Part 1: Prophylaxis. Current Oncology, 22(2), 133-143. https://doi.org/10.3747/co.22.2586

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