Cancer and thrombosis

Haema 2014; 5(1):68-77

by Anna Christoforidou

Haematology Clinic, University General Hospital of Alexandroupolis, Greece

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Cancer patients have a range of hemostatic abnormalities that predispose to thrombosis. Thromboembolic disease is a frequent complication of cancer which is also associated with decreased overall survival of patients. Risk factors are patient-associated, disease-associated such as the tumor type, stage, and treatment-associated, i.e., chemotherapy and surgery. Recent data from basic research suggests that hemostasis and cancer biology are interconnected at multiple levels. It seems that hemostasis and cancer create a vicious circle in which the hypercoagulability increases the aggressiveness of the cancer and vice versa. The treatment of thrombosis in a cancer patient varies in relation to the patient without cancer. Leading scientific societies and organizations have published guidelines in order to incorporate the results of large randomized trials to clinical practice. This review focuses on the epidemiology and risk factors of thrombotic complications of cancer and their pathogenesis together with new insights into the interaction between hemostasis and cancer biology. Finally, a comparative presentation of guidelines for the prophylaxis and treatment of thrombosis in patients with malignancies is outlined.