CC BY 4.0 · TH Open 2018; 02(04): e373-e386
DOI: 10.1055/s-0038-1675577
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Cancer-Associated Thrombosis: Beyond Clinical Practice Guidelines—A Multidisciplinary (SEMI–SEOM–SETH) Expert Consensus

Vanessa Pachón
1   Department of Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
,
Javier Trujillo-Santos
2   Department of Internal Medicine, Hospital Universitario Santa Lucía, Cartagena, Spain
,
Pere Domènech
3   Thrombosis and Haemostasis Unit, Hospital Universitario Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
,
Enrique Gallardo
4   Department of Oncology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
,
Carmen Font
5   Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
,
José Ramón González-Porras
6   Hematology Service, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
,
Pedro Pérez-Segura
7   Department of Oncology, Hospital Clínico San Carlos, Madrid, Spain
,
Ana Maestre
8   Department of Internal Medicine, Hospital del Vinalopó, Elche, Spain
,
José Mateo
9   Hematology Service, Hospital Santa Creu i Sant Pau, Barcelona, Spain
,
Andrés Muñoz
10   Department of Oncology, Hospital Universitario Gregorio Marañón, Madrid, Spain
,
María Luisa Peris
11   Department of Internal Medicine, Hospital Provincial de Castellón, Castellón, Spain
,
Ramón Lecumberri
12   Hematology Service, Clínica Universidad de Navarra, IDISNA, CIBER-CV, Pamplona, Spain
› Institutsangaben
Funding This work has been performed with an unrestricted grant from Aspen, Leo-Pharma, Laboratorios Farmacéuticos Rovi, and Sanofi.
Weitere Informationen

Publikationsverlauf

12. April 2018

17. September 2018

Publikationsdatum:
05. November 2018 (online)

Abstract

Despite the growing interest and improved knowledge about venous thromboembolism in cancer patients in the last years, there are still many unsolved issues. Due to the limitations of the available literature, evidence-based clinical practice guidelines are not able to give solid recommendations for challenging scenarios often present in the setting of cancer-associated thrombosis (CAT). A multidisciplinary expert panel from three scientific societies—Spanish Society of Internal Medicine (SEMI), Spanish Society of Medical Oncology (SEOM), and Spanish Society Thrombosis and Haemostasis (SETH)—agreed on 12 controversial questions regarding prevention and management of CAT, which were thoroughly reviewed to provide further guidance. The suggestions presented herein may facilitate clinical decisions in specific complex circumstances, until these can be made leaning on reliable scientific evidence.

 
  • References

  • 1 Lyman GH, Khorana AA, Kuderer NM. , et al; American Society of Clinical Oncology Clinical Practice. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2013; 31 (17) 2189-2204
  • 2 Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ. ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl): 7S-47S
  • 3 Mandalà M, Falanga A, Roila F. ; ESMO Guidelines Working Group. Management of venous thromboembolism (VTE) in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 2011; 22 (Suppl. 06) vi85-vi92
  • 4 Farge D, Debourdeau P, Beckers M. , et al. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. J Thromb Haemost 2013; 11 (01) 56-70
  • 5 Muñoz AJ, Viñolas N, Cubedo R, Isla D. SEOM guidelines on thrombosis in cancer patients. Clin Transl Oncol 2011; 13 (08) 592-596
  • 6 Jimenez-Fonseca P, Carmona-Bayonas A, Calderon C. , et al. FOTROCAN Delphi consensus statement regarding the prevention and treatment of cancer-associated thrombosis in areas of uncertainty and low quality of evidence. Clin Transl Oncol 2017; 19 (08) 997-1009
  • 7 Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 2008; 111 (10) 4902-4907
  • 8 Mansfield AS, Tafur AJ, Wang CE, Kourelis TV, Wysokinska EM, Yang P. Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer. J Thromb Haemost 2016; 14 (09) 1773-1778
  • 9 Chaudhury A, Balakrishnan A, Thai C. , et al. Validation of the Khorana score in a large cohort of cancer patients with venous thromboembolism. Blood 2016; 128: 879
  • 10 Srikanthan A, Tran B, Beausoleil M. , et al. Large retroperitoneal lymphadenopathy as a predictor of venous thromboembolism in patients with disseminated germ cell tumors treated with chemotherapy. J Clin Oncol 2015; 33 (06) 582-587
  • 11 Muñoz Martín AJ, Ortega I, Font C. , et al. Multivariable clinical-genetic risk model for predicting venous thromboembolic events in patients with cancer. Br J Cancer 2018; 118 (08) 1056-1061
  • 12 Van Es N, Di Nisio M, Cesarman G. , et al. Comparison of risk prediction scores for cancer-associated venous thromboembolism: a prospective cohort study. Haematologica 2017; 102 (09) 1494-1501
  • 13 Gerotziafas GT, Taher A, Abdel-Razeq H. , et al; COMPASS–CAT Working Group. A predictive score for thrombosis associated with breast, colorectal, lung, or ovarian cancer: the prospective COMPASS-Cancer-Associated Thrombosis Study. Oncologist 2017; 22 (10) 1222-1231
  • 14 Cella CA, Di Minno G, Carlomagno C. , et al. Preventing venous thromboembolism in ambulatory cancer patients: the ONKOTEV Study. Oncologist 2017; 22 (05) 601-608
  • 15 Pabinger I, van Es N, Heinze G. , et al. A clinical prediction model for cancer-associated venous thromboembolism: a development and validation study in two independent prospective cohorts. Lancet Haematol 2018; 5 (07) e289-e298
  • 16 Soria JM, López S. [The genetics of thrombosis in cancer]. Med Clin (Barc) 2015; 144 (Suppl. 01) 26-30
  • 17 Antic D, Biljana M, Milic N. , et al. Internal and external validation of THROLY (thrombosis lymphoma) score. Thromb Res 2018; 164 (suppl 1): S187
  • 18 Norris LA, Abu Saadeh F, Ward M. , et al. Development and validation of a risk model for prediction of venous thromboembolism in gynaecological cancer patients. Thromb Res 2018; 164 (suppl 1): S183-S184
  • 19 Harenberg J, Roebruck P, Heene DL. ; The Heparin Study in Internal Medicine Group. Subcutaneous low-molecular-weight heparin versus standard heparin and the prevention of thromboembolism in medical inpatients. Haemostasis 1996; 26 (03) 127-139
  • 20 Lechler E, Schramm W, Flosbach CW. ; The Prime Study Group. The venous thrombotic risk in non-surgical patients: epidemiological data and efficacy/safety profile of a low-molecular-weight heparin (enoxaparin). Haemostasis 1996; 26 (Suppl. 02) 49-56
  • 21 Samama MM, Cohen AT, Darmon JY. , et al; Prophylaxis in Medical Patients with Enoxaparin Study Group. A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. N Engl J Med 1999; 341 (11) 793-800
  • 22 Leizorovicz A, Cohen AT, Turpie AG, Olsson CG, Vaitkus PT, Goldhaber SZ. ; PREVENT Medical Thromboprophylaxis Study Group. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation 2004; 110 (07) 874-879
  • 23 Cohen AT, Davidson BL, Gallus AS. , et al; ARTEMIS Investigators. Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ 2006; 332 (7537): 325-329
  • 24 Carrier M, Khorana AA, Moretto P, Le Gal G, Karp R, Zwicker JI. Lack of evidence to support thromboprophylaxis in hospitalized medical patients with cancer. Am J Med 2014; 127 (01) 82-6.e1
  • 25 Giantonio BJ, Catalano PJ, Meropol NJ. , et al; Eastern Cooperative Oncology Group Study E3200. Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 2007; 25 (12) 1539-1544
  • 26 Hurwitz H, Fehrenbacher L, Novotny W. , et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350 (23) 2335-2342
  • 27 Van Cutsem E, Rivera F, Berry S. , et al; First BEAT Investigators. Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol 2009; 20 (11) 1842-1847
  • 28 Flynn PJ, Sugrue MM, Purdie DM. , et al. Serious bleeding events are uncommon in patients with metastatic colorectal cancer receiving bevacizumab as part of a first-line regimen: results from the BRiTE Observational Cohort Study. J Clin Oncol 2008; 26 (Suppl 15): 4104
  • 29 Griesinger F, Laskin JJ, Pavlakis N. Safety of first-line bevacizumab-based therapy with concomitant cardiovascular or anticoagulation medication in advanced or recurrent non-squamous non-small cell lung cancer (NSCLC) in MO19390 (SAiL). J Clin Oncol 2008; 26 (Suppl 15): 8049
  • 30 Hambleton J, Novotny WF, Hurwitz H. , et al. Bevacizumab does not increase bleeding in patients with metastatic colorectal cancer receiving concurrent anticoagulation. J Clin Oncol 2004; 22 (Suppl 14): 3528
  • 31 Wardley A, Lohrisch C, Joy AA. , et al. Effect of anticoagulation therapy on bleeding and thromboembolic events (TEs) in the AVADO phase III study of docetaxel (D) ± bevacizumab (BV) in inoperable locally recurrent (LR) or metastatic breast cancer (mBC). Cancer Res 2009; 69 (Suppl. 02) 1035
  • 32 Leighl NB, Bennouna J, Yi J, Moore N, Hambleton J, Hurwitz H. Bleeding events in bevacizumab-treated cancer patients who received full-dose anticoagulation and remained on study. Br J Cancer 2011; 104 (03) 413-418
  • 33 Hurwitz HI, Saltz LB, Van Cutsem E. , et al. Venous thromboembolic events with chemotherapy plus bevacizumab: a pooled analysis of patients in randomized phase II and III studies. J Clin Oncol 2011; 29 (13) 1757-1764
  • 34 Abdel-Razeq H, Mansour A, Ismael Y, Abdulelah H. Inferior vena cava filters in cancer patients: to filter or not to filter. Ther Clin Risk Manag 2011; 7: 99-102
  • 35 Mansour A, Ismael Y, Abdel-Razeq H. Inferior vena cava filters in patients with advanced-stage cancer. Hematol Oncol Stem Cell Ther 2014; 7 (04) 136-141
  • 36 Barginear MF, Gralla RJ, Bradley TP. , et al. Investigating the benefit of adding a vena cava filter to anticoagulation with fondaparinux sodium in patients with cancer and venous thromboembolism in a prospective randomized clinical trial. Support Care Cancer 2012; 20 (11) 2865-2872
  • 37 Mikhail S, Hannan L, Pishvaian MJ, Kessler C. Retrievable inferior vena cava filters in patients with cancer are safe but are they beneficial?. Med Oncol 2015; 32 (06) 622
  • 38 Abtahian F, Hawkins BM, Ryan DP. , et al. Inferior vena cava filter usage, complications, and retrieval rate in cancer patients. Am J Med 2014; 127 (11) 1111-1117
  • 39 Brunson A, Ho G, White R, Wun T. Inferior vena cava filters in patients with cancer and venous thromboembolism (VTE) does not improve clinical outcomes: a population-based study. Thromb Res 2017; 153: 57-64
  • 40 Coombs C, Kuk D, Devlin S. , et al. Outcomes after inferior vena cava filter placement in cancer patients diagnosed with pulmonary embolism: risk for recurrent venous thromboembolism. J Thromb Thrombolysis 2017; 44 (04) 489-493
  • 41 Carrier M, Khorana AA, Zwicker J, Noble S, Lee AY. ; Subcommittee on Haemostasis and Malignancy for the SSC of the ISTH. Management of challenging cases of patients with cancer-associated thrombosis including recurrent thrombosis and bleeding: guidance from the SSC of the ISTH. J Thromb Haemost 2013; 11 (09) 1760-1765
  • 42 Lyman GH, Bohlke K, Khorana AA. , et al; American Society of Clinical Oncology. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology Clinical Practice Guideline update 2014. J Clin Oncol 2015; 33 (06) 654-656
  • 43 Kearon C, Akl EA, Ornelas J. , et al. Antithrombotic therapy for VTE disease. Chest guideline and expert panel report. Chest 2016; 149 (02) 315-352
  • 44 Farge D, Bounameaux H, Brenner B. , et al. International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer. Lancet Oncol 2016; 17 (10) e452-e466
  • 45 Duffett L, Carrier M. Inferior vena cava filters. J Thromb Haemost 2017; 15 (01) 3-12
  • 46 Pandhi MB, Desai KR, Ryu RK, Lewandowski RJ. The role of inferior vena cava filters in cancer patients. Semin Intervent Radiol 2016; 33 (02) 71-74
  • 47 American Society of Hematology. Ten things physicians and patients should question. Available at: http://www.choosingwisely.org/wp-content/uploads/2015/02/ASH-Choosing-Wisely-List.pdf . Accessed October 15, 2018
  • 48 Lee AY, Peterson EA. Treatment of cancer-associated thrombosis. Blood 2013; 122 (14) 2310-2317
  • 49 Elalamy I, Mahé I, Ageno W, Meyer G. Long-term treatment of cancer-associated thrombosis: the choice of the optimal anticoagulant. J Thromb Haemost 2017; 15 (05) 848-857
  • 50 Francis CW, Kessler CM, Goldhaber SZ. , et al. Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. J Thromb Haemost 2015; 13 (06) 1028-1035
  • 51 Jara-Palomares L, Solier-Lopez A, Elias-Hernandez T. , et al. Tinzaparin in cancer associated thrombosis beyond 6 months: TiCAT study. Thromb Res 2017; 157: 90-96
  • 52 Noble S, Sui J. The treatment of cancer associated thrombosis: does one size fit all? Who should get LMWH/warfarin/DOACs?. Thromb Res 2016; 140 (Suppl. 01) S154-S159
  • 53 Zwicker JI, Bauer KA. How long is long enough? Extended anticoagulation for the treatment of cancer-associated deep vein thrombosis. J Clin Oncol 2014; 32 (32) 3596-3599
  • 54 Raskob GE, van Es N, Verhamme P. , et al; Hokusai VTE Cancer Investigators. Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med 2018; 378 (07) 615-624
  • 55 Lee AY, Levine MN, Baker RI. , et al; Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer (CLOT) Investigators. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349 (02) 146-153
  • 56 Young AM, Marshall A, Thirlwall J. , et al. Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: results of a randomized trial (SELECT-D). J Clin Oncol 2018; 36 (20) 2017-2023
  • 57 Streiff MB, Holmstrom B, Ashrani A. , et al. Cancer-associated venous thromboembolic disease, version 1.2015. J Natl Compr Canc Netw 2015; 13 (09) 1079-1095
  • 58 Olmos VP, Ramos Gallo MJ, Rebollo MA. , et al; Sociedad Española de Oncología Médica (SEOM); Sociedad Española de Angiología y Cirugía Vascular (SEACV). Manejo de la enfermedad tromboembólica venosa en pacientes oncológicos: guías de práctica clínica española. Consenso SEACV-SEOM. Med Clin (Barc) 2015; 144 (Suppl. 01) 3-15
  • 59 Debourdeau P, Farge D, Beckers M. , et al. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost 2013; 11 (01) 71-80
  • 60 Baumann Kreuziger L, Cote L, Verhamme P. , et al; RIETE Investigators. A RIETE registry analysis of recurrent thromboembolism and hemorrhage in patients with catheter-related thrombosis. J Vasc Surg Venous Lymphat Disord 2015; 3 (03) 243-50.e1
  • 61 Delluc A, Le Gal G, Scarvelis D, Carrier M. Outcome of central venous catheter associated upper extremity deep vein thrombosis in cancer patients. Thromb Res 2015; 135 (02) 298-302
  • 62 Levin JM, Schiff D, Loeffler JS, Fine HA, Black PM, Wen PY. Complications of therapy for venous thromboembolic disease in patients with brain tumors. Neurology 1993; 43 (06) 1111-1114
  • 63 Donato J, Campigotto F, Uhlmann EJ. , et al. Intracranial hemorrhage in patients with brain metastases treated with therapeutic enoxaparin: a matched cohort study. Blood 2015; 126 (04) 494-499
  • 64 Chai-Adisaksopha C, Linkins LA, ALKindi SY, Cheah M, Crowther MA, Iorio A. Outcomes of low-molecular-weight heparin treatment for venous thromboembolism in patients with primary and metastatic brain tumours. Thromb Haemost 2017; 117 (03) 589-594
  • 65 Zwicker JI, Karp Leaf R, Carrier M. A meta-analysis of intracranial hemorrhage in patients with brain tumors receiving therapeutic anticoagulation. J Thromb Haemost 2016; 14 (09) 1736-1740
  • 66 Ageno W, Riva N, Schulman S. , et al. Long-term clinical outcomes of splanchnic vein thrombosis. Results of an International Registry. JAMA Intern Med 2015; 175 (09) 1474-1480
  • 67 Riva N, Ageno W, Schulman S. , et al; International Registry on Splanchnic Vein Thrombosis (IRSVT) study group. Clinical history and antithrombotic treatment of incidentally detected splanchnic vein thrombosis: a multicentre, international prospective registry. Lancet Haematol 2016; 3 (06) e267-e275
  • 68 Tufano A, Ageno W, Di Micco P. , et al; RIETE Investigators. Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis. Thromb Res 2018; 164: 69-74
  • 69 Easaw JC, Shea-Budgell MA, Wu CM. , et al. Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 2: treatment. Curr Oncol 2015; 22 (02) 144-155
  • 70 Oo TH. Management of challenging cases of patients with cancer-associated thrombosis including recurrent thrombosis and bleeding: guidance from the SSC of the ISTH: a rebuttal. J Thromb Haemost 2014; 12 (01) 115-116
  • 71 Ibrahim RB, Skewes MD, Kuriakose P. “Sailing in troubled waters”: a review of the use of anticoagulation in adult cancer patients with thrombocytopenia. Blood Coagul Fibrinolysis 2016; 27 (06) 615-630
  • 72 Samuelson Bannow BT, Walter RB, Gernsheimer TB, Garcia DA. Patients treated for acute VTE during periods of treatment-related thrombocytopenia have high rates of recurrent thrombosis and transfusion-related adverse outcomes. J Thromb Thrombolysis 2017; 44 (04) 442-447
  • 73 Mantha S, Miao Y, Wills J, Parameswaran R, Soff GA. Enoxaparin dose reduction for thrombocytopenia in patients with cancer: a quality assessment study. J Thromb Thrombolysis 2017; 43 (04) 514-518
  • 74 Samuelson Bannow BT, Lee A, Khorana AA. , et al. Management of cancer-associated thrombosis in patients with thrombocytopenia: guidance from the SSC of the ISTH. J Thromb Haemost 2018; 16 (06) 1246-1249
  • 75 Hutten BA, Prins MH, Gent M, Ginsberg J, Tijssen JG, Büller HR. Incidence of recurrent thromboembolic and bleeding complications among patients with venous thromboembolism in relation to both malignancy and achieved international normalized ratio: a retrospective analysis. J Clin Oncol 2000; 18 (17) 3078-3083
  • 76 Hirsh J, Bauer KA, Donati MB. , et al. Parenteral anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008; 133 (6, Suppl): 141S-159S
  • 77 Macle L, Cairns J, Leblanc K. , et al; CCS Atrial Fibrillation Guidelines Committee. 2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. Can J Cardiol 2016; 32 (10) 1170-1185
  • 78 You JJ, Singer DE, Howard PA. , et al. Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl): e531S-e575S
  • 79 Rubboli A, Halperin JL, Airaksinen KE. , et al. Antithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting. An expert consensus document with focus on atrial fibrillation. Ann Med 2008; 40 (06) 428-436
  • 80 Kirchhof P, Benussi S, Kotecha D. , et al; ESC Scientific Document Group. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37 (38) 2893-2962
  • 81 Martin K. Risk factors for and management of MPN-associated bleeding and thrombosis. Curr Hematol Malig Rep 2017; 12 (05) 389-396
  • 82 Landolfi R, Marchioli R, Kutti J. , et al; European Collaboration on Low-Dose Aspirin in Polycythemia Vera Investigators. Efficacy and safety of low-dose aspirin in polycythemia vera. N Engl J Med 2004; 350 (02) 114-124
  • 83 De Stefano V, Za T, Rossi E. , et al; GIMEMA CMD-Working Party. Recurrent thrombosis in patients with polycythemia vera and essential thrombocythemia: incidence, risk factors, and effect of treatments. Haematologica 2008; 93 (03) 372-380
  • 84 Lee AYY, Kamphuisen PW, Meyer G. , et al; CATCH Investigators. Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: a randomized clinical trial. JAMA 2015; 314 (07) 677-686
  • 85 Meyer G, Marjanovic Z, Valcke J. , et al. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study. Arch Intern Med 2002; 162 (15) 1729-1735
  • 86 Kreuziger LB, Streiff M. Anti-Xa monitoring of low-molecular-weight heparin in adult patients with cancer. Hematology (Am Soc Hematol Educ Program) 2016; 2016 (01) 206-207
  • 87 Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl): e24S-e43S
  • 88 Muñoz Martín AJ, Font Puig C, Navarro Martín LM, Borrega García P, Martín Jiménez M. ; Spanish Society for Medical Oncology. Clinical guide SEOM on venous thromboembolism in cancer patients. Clin Transl Oncol 2014; 16 (12) 1079-1090
  • 89 Lim W. Using low molecular weight heparin in special patient populations. J Thromb Thrombolysis 2010; 29 (02) 233-240
  • 90 Connors JM. Thrombophilia testing and venous thrombosis. N Engl J Med 2017; 377 (12) 1177-1187
  • 91 Kearon C, Akl EA, Comerota AJ. , et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2, Suppl): e419S-e496S
  • 92 Baglin T, Bauer K, Douketis J, Buller H, Srivastava A, Johnson G. ; SSC of the ISTH. Duration of anticoagulant therapy after a first episode of an unprovoked pulmonary embolus or deep vein thrombosis: guidance from the SSC of the ISTH. J Thromb Haemost 2012; 10 (04) 698-702
  • 93 Howard LS, Hughes RJ. NICE guideline: management of venous thromboembolic diseases and role of thrombophilia testing. Thorax 2013; 68 (04) 391-393
  • 94 Horowitz N, Brenner B. Thrombophilia and cancer. Pathophysiol Haemost Thromb 2008; 36 (3-4): 131-136
  • 95 Baglin T, Gray E, Greaves M. , et al; British Committee for Standards in Haematology. Clinical guidelines for testing for heritable thrombophilia. Br J Haematol 2010; 149 (02) 209-220
  • 96 van Sluis GL, Söhne M, El Kheir DY, Tanck MW, Gerdes VE, Büller HR. Family history and inherited thrombophilia. J Thromb Haemost 2006; 4 (10) 2182-2187