Hyperviscosity syndrome in patients with ovarian carcinoma

Tempelhoff, Georg–Friedrich von; Heilmann, L.; Hommel, Gerhard; Schneider, D.; Niemann, F; Zoller, Henry

doi:10.1002/(sici)1097-0142(19980315)82:6<1104::aid-cncr14>3.0.co;2-a

Cited by 33 publications

(28 citation statements)

References 24 publications

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“…Although monoclonal gammopathy can result in an increased risk of bleeding because of thrombopathy or disorders in the coagulation factors, the hyperviscosity will cause hypercoagulation [18]. In the patient concerned, neither high levels of IgG nor signs of a myeloma were found.…”

Section: Discussionmentioning

confidence: 81%

Deep venous thrombosis after laparoscopic cholecystectomy and prevention with nadroparin

2001

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Section: Discussionmentioning

confidence: 81%

Deep venous thrombosis after laparoscopic cholecystectomy and prevention with nadroparin

2001

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“…The platelet count should be monitored weekly in the first month to detect heparin-induced thrombocytopenia (HIT). It should also be noted that the use of anticoagulants, especially LMWHs, in malignancy might constitute a new approach for therapy since a number of recent trials have demonstrated an improvement of cancer outcome with respect to patients overall survival in association with these drugs (42,(107)(108)(109)(110). SUMMARY Thromboembolism is a severe and frequent problem in gynecologic malignancy.…”

Section: Recommendations For Thrombosis Prophylaxis During Cytoreductmentioning

confidence: 99%

State-of-the-Art Review : Chemotherapy and Thrombosis in Gynecologic Malignancy

Gf¹,

Pollow²,

Schneider³

et al. 1999

Clin Appl Thromb Hemost

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The occurrence of deep vein thrombosis (DVT) in gynecologic cancer patients has a multifactorial genesis.Besides the older age of patients and the coexistence of additional thrombosis favoring illnesses such as obesity, hypertension, metabolic and cardiovascular disorders, and others, therapeutic management can be an independent risk factor for DVT. Radical surgery for pelvic genital cancer leads to an incidence of postoperative DVT between 6% in ovarian cancer and up to 20% in cervical or endometrial cancer patients (1). The rate for DVT after breast cancer surgery does not exceed 3 % (2-4) and breast cancer patients under observation were found to experience DVT at a rate of 0% to 3.28% (5-7) compared to an overall incidence per year of about 0.3% in women (8). Radiotherapy, especially during intrauterine/ vaginal radium application for 12 to 24 hours, in uterine cancer patients has a reported rate between 2.5% and 6.8%. These rates occur whether or not thrombosis prophylaxis with either a daily dose of low molecular weight heparin (LMWH) administered subcutaneously or oral anticoagulation with warfarin was given (9-11). In a recent postmortem study (12), among 966 consecutive autopsies with thrombosis and/or pulmonary embolism (PE), cancer was coincident in 56% of cases. Breast cancer (5.7%) and cervical cancer (2.4%) were among the four most frequent cancer types and were significantly over represented when compared to a control group of 325 consecutive and unselected autopsies without DVT (3.1 % and 0.6%; p < .05).The most comprehensive data on thrombotic complications in gynecologic malignancy were drawn from studies of breast cancer patients in association with cytoreductive therapy and showed an approximate average incidence of 5%. These results are substantial since most patients with breast and ovarian cancer will receive chemotherapy for adjuvant and/or palliative settings some time in the course of their disease.Deep vein thrombosis is a frequent complication in gynecologic malignancy and should be considered when planning therapeutic management of patients. This article discusses the prethrombotic state and the rate of thrombotic complications in patients receiving standard cytoreductive therapy for breast and ovarian cancer and the possible mechanisms of chemotherapy-induced thrombosis. The results of recent thrombosis prevention trials are summarized.

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“…Deep-vein thrombosis (DVT) and subsequent pulmonary thromboembolism (PTE) represent potentially lethal perioperative complications associated with surgery for ovarian cancer (von Tempelhoff et al, 1998). Deep-vein thrombosis is known to occur in the postoperative period or during the course of postoperative chemotherapy in 13.6 -27.0% of ovarian cancer patients (ClarkePearson et al, 1983;von Tempelhoff et al, 1998).…”

mentioning

confidence: 99%

“…Deep-vein thrombosis is known to occur in the postoperative period or during the course of postoperative chemotherapy in 13.6 -27.0% of ovarian cancer patients (ClarkePearson et al, 1983;von Tempelhoff et al, 1998). Several guidelines (Greets et al, 2001;Nicolaides et al, 2001) have focused on intraand postoperative managements for prevention of venous thromboembolism (VTE).…”

mentioning

confidence: 99%

High incidence of silent venous thromboembolism before treatment in ovarian cancer

et al. 2007

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Venous thromboembolism (VTE) such as deep-vein thrombosis (DVT) and pulmonary thromboembolism (PTE) often occurs after surgery and rarely occurs even before surgery in patients with ovarian cancer. It is well known that levels of plasma D-dimer (DD) before treatment in most ovarian cancer patients are increased. This study therefore examined whether increased levels of DD are associated with presence of VTE before treatment of ovarian cancer. Between November 2004 and March 2007, DD levels prior to initial treatment were measured in 72 consecutive patients with presumed epithelial ovarian cancer (final diagnosis: epithelial ovarian cancer, n ¼ 60; and epithelial ovarian borderline malignancy, n ¼ 12). Venous ultrasound imaging (VUI) of the lower extremity was conducted for all patients except for two patients in whom DVT was detected by pelvic computed tomography (CT). When DVT was found, pulmonary scintigraphy was subsequently performed to ascertain presence of PTE. D-dimer levels were above the cut-off value (0.5 mg ml À1 ) in 65 of 72 patients (90.2%). Venous ultrasound imaging or CT revealed DVT in 18 of 72 patients (25.0%) and pulmonary scintigraphy found PTE in 8 patients (11.1%). All patients with VTE were asymptomatic when VTE was found. D-dimer levels were associated with incidence of VTE (0 -1.4 mg ml À1 ; 0 of 26 (0%), 1.5 -7.4 mg ml À1 ; 9 of 30 (30%) and X7.5 mg ml À1 ; 9 of 16 (56.3%), P for trend ¼ 0.0003). However, even if 1.5 mg ml À1 was used as a cut-off value, this had low specificity and positive predictive value (47.2, 38.3%), though it had high sensitivity and negative predictive value (100, 100%). Therefore, ovarian cancer patients with DD level X1.5 mg ml À1 should be examined using VUI to detect silent DVT. Patients with VTE underwent preventive managements including anticoagulant therapy before initial treatment, chemotherapy or surgery, and after surgery. There was no clinical onset of postoperative VTE in all 72 patients. Measurement of DD levels and subsequent ultrasonography revealed that silent or subclinical VTE frequently occurs before surgery in ovarian cancer. The usefulness of preoperative assessment of VTE needs further confirmation in randomised controlled trials.

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Hyperviscosity syndrome in patients with ovarian carcinoma

Cited by 33 publications

References 24 publications

Deep venous thrombosis after laparoscopic cholecystectomy and prevention with nadroparin

Deep venous thrombosis after laparoscopic cholecystectomy and prevention with nadroparin

State-of-the-Art Review : Chemotherapy and Thrombosis in Gynecologic Malignancy

High incidence of silent venous thromboembolism before treatment in ovarian cancer

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