Epidemiology of venous thromboembolism in 9489 patients with malignant glioma

Semrad, Thomas J.; O’Donnell, Robert T.; Wun, Theodore; Chew, Helen K.; Harvey, Danielle; Zhou, Hong; White, Richard

doi:10.3171/jns.2007.106.4.601

Cited by 252 publications

(164 citation statements)

References 40 publications

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“…This may be especially true for brain tumor patients in whom the high VTE risk exceeds the postoperative period and stays high throughout the course of disease. [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Circulating procoagulant microparticles in cancer patients

Thaler

Weinstabl

et al. 2010

Ann Hematol

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Accumulating evidence indicates that microparticles (MPs) are important mediators of the interaction between cancer and the hemostatic system. We conducted a large prospective cohort study to determine whether the number of circulating procoagulant MPs is elevated in cancer patients and whether the elevated MP levels are predictive of occurrence of venous thrombembolism (VTE). We analyzed plasma samples of 728 cancer patients from the ongoing prospective observational Vienna Cancer and Thrombosis Study (CATS). Study endpoint was the occurrence of symptomatic VTE. Sixty-five age-and sex-matched healthy controls were recruited for defining the cut-off point for elevated MPs (4.62 nanomolar phosphatidylserine nM PS ), which was set at the 95th percentile of MP levels in healthy controls. The measurement of MPs was performed after capture onto immobilized annexin-V, and determination of their procoagulant activity was quantified with a prothrombinase assay. During a median observation period of 710 days 53 patients developed VTE. MP levels (nM PS) were significantly higher in cancer patients than in healthy controls (median 25th-75th percentile : 3.95 1.74-7.96 vs. 1.19 0.81-1.67 , p<0.001). Multivariate analysis including age, sex, surgery, chemo-and radiotherapy showed no statistically significant association of the hazard ratio of elevated MPs with VTE (0.95 [95% CI: 0.55-1.64], p=0.856). In conclusion, MP levels were elevated in cancer patients compared to healthy individuals in this study. However, elevated MP levels were not predictive of VTE.

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“…This may be especially true for brain tumor patients in whom the high VTE risk exceeds the postoperative period and stays high throughout the course of disease. [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Circulating procoagulant microparticles in cancer patients

Thaler

Weinstabl

et al. 2010

Ann Hematol

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“…The high incidence of deep vein thrombosis and pulmonary embolism in patients with HGG confounds separation as an independent toxicity of antiangiogenic therapies, although antiangiogenic therapy may aggravate this thrombogenic predisposition. [51][52][53][54] A retrospective review of bevacizumab plus therapy in patients with recurrent HGG suggests that concurrent use of anticoagulation appears safe without an apparent increased risk of hemorrhage. 33 In conclusion, bevacizumab as a single agent used at this dose and schedule in patients with previously treated alkylator chemotherapy-refractory recurrent 1p19q codeleted AO appears of benefit (as determined by response rate and PFS-6) for recurrent alkylator-refractory AO/ AOA.…”

Section: Original Articlementioning

confidence: 99%

Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma

Chamberlain

Johnston

2009

Cancer

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BACKGROUND:A retrospective evaluation of single agent bevacizumab was carried out in adults with recurrent alkylator‐refractory 1p19q codeleted anaplastic oligodendrogliomas (AO) with an objective of determining progression‐free survival (PFS). There is no standard therapy for alkylator‐resistant AO, and hence a need exists for new therapies.METHODS:Twenty‐two patients aged 24 to 60 years with recurrent AO were treated. All patients had previously been treated with surgery, radiotherapy, adjuvant chemotherapy (temozolomide, 17; carmustine wafers, 4; carmustine, 1), and 1 salvage regimen (procarbazine, lomustine, and vincristine, 15; temozolomide, 6; carmustine wafers, 1). Eleven patients underwent repeat surgery. Patients were treated at second recurrence with bevacizumab, once every 2 weeks, defined as a single cycle. Neurological evaluation was performed every 2 weeks, and neuroradiographic assessment was made after the initial 2 cycles of bevacizumab and subsequently after every 4 cycles of bevacizumab.RESULTS:A total of 391 cycles of bevacizumab (median, 14.5 cycles; range, 2‐39 cycles) were administered. Bevacizumab‐related toxicity included fatigue (14 patients; 4 grade 3), leukopenia (9; 1 grade 3), anemia (5; 0 grade 3), hypertension (5; 1 grade 3), deep vein thrombosis (4; 1 grade 3), and wound dehiscence (2; 1 grade 3). Fifteen (68%) patients demonstrated a partial radiographic response, 1 (5.0%) demonstrated stable disease, and 6 (27%) demonstrated progressive disease after 2 cycles of bevacizumab. Time to tumor progression ranged from 1 to 18 months (median, 6.75 months). Survival ranged from 3 to 19 months (median, 8.5 months). Six‐month and 12‐month PFS were 68% and 23%, respectively.CONCLUSIONS:Bevacizumab demonstrated efficacy and acceptable toxicity in this cohort of adults with recurrent 1p19q codeleted alkylator‐refractory AO. Cancer 2009. © 2009 American Cancer Society.

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“…VTE filters are placed most frequently in the inferior vena cava (IVC) to prevent a circulating clot from becoming a PE. IVC filters have been shown to be extremely effective in preventing the development of PE and in decreasing the morbidity and mortality of patients known to be harboring VTE of any kind [10,11,32,34].…”

Section: Treatment For Vtementioning

confidence: 99%

“…Patients harboring brain tumors are more likely to develop VTE than patients who have cancers in other sites (Table 1) . Studies have shown that other risk factors for VTE include age, sex, ethnicity, blood type, length of hospital stay, operative duration, and coagulation status [3,6,[8][9][10]14,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Standard prophylactic measures for VTE include chemical anticoagulation, mechanical prophylaxis, and increased ambulation during the post-operative period [36,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54].…”

Section: Introductionmentioning

confidence: 99%

Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

Coté¹,

Smith

2015

J Hematol Thrombo Dis

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Venous thromboembolism (VTE) is a relatively common and well-described condition, affecting approximately 1-2% of the general population. VTE can lead to significant morbidity and death via pulmonary embolism (PE). During the post-operative period, VTE occurs at higher rates due to natural thrombotic responses to injury and limited post-operative mobility. In general, rates of post-operative VTE are higher in patients undergoing operations for cranial and spinal lesions than for lesions of other types, a phenomenon that is not fully explained. Several studies have demonstrated that other risk factors for VTE include age, sex, ethnicity, hospital stay length, and coagulation state. Aggressive chemical and mechanical measures for VTE prophylaxis are indicated in the postoperative period to prevent the formation of VTE. Here we review the literature on VTE in brain tumor patients, with a focus on their etiology, diagnosis, treatment, and prophylaxis.

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Epidemiology of venous thromboembolism in 9489 patients with malignant glioma

Cited by 252 publications

References 40 publications

Circulating procoagulant microparticles in cancer patients

Circulating procoagulant microparticles in cancer patients

Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma

Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

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