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Semin Thromb Hemost 2002; 28(1): 79-88
DOI: 10.1055/s-2002-20566
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Improved Cancer Mortality with Low-Molecular-Weight Heparin Treatment: A Review of the Evidence

Richard H. Cosgrove1 , Leo R. Zacharski2 , Eric Racine3 , Judith C. Andersen4
  • 1Department of Pharmacy, Harper University Hospital, Detroit Medical Center, Detroit, Michigan
  • 2Department of Veteran's Affairs Medical Center, White River Junction, Vermont, and Department of Medicine, Dartmouth Medical School, Lebanon, New Hampshire
  • 3Clinical Pharmacy Services, Harper University Hospital, Detroit Medical Center and Wayne State University School of Pharmacy, Detroit, Michigan
  • 4Department of Medicine, Wayne State University, Harper University Hospital, Detroit, Michigan
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Publication History

Publication Date:
05 March 2002 (online)

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ABSTRACT

Work with low-molecular-weight heparins (LMWHs) continues to provide suggestions for survival advantages among patients with cancer diagnoses. Momentum is building in support of this theory through reports, the vast majority of which are derived from secondary analyses of clinical trials on the treatment of thromboembolism. The data retrieved from such studies that compare unfractionated heparin (UFH) with LMWH indicate that LMWH is equally beneficial if not more beneficial to cancer patients in terms of survival. In retrospective analysis, this improved life expectancy is not considered a result of reduced complications from thromboembolism. Thus, theories of antitumor effects of LMWH have developed, supported by evidence that most of the survival benefits are during long-term comparisons. Reports describing the effects of heparin in the setting of cancer have existed for over a half-century, although specific mechanisms for the marginal results seen thus far have yet to surface. Proposals for the most likely targets of the effective heparins include enzyme interaction, cellular growth modifications, and antiangiogenesis.

KEYWORD

Low-molecular-weight heparin - cancer - mortality

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