Thromboembolic Disease in Haemophilic Patients Undergoing Major Orthopaedic Surgery: Is Thromboprophylaxis Mandatory?

Bădulescu, Oana Viola; Bojan, Iris Bararu; Bădescu, Magda; Filip, Nina; Nedelcu, Alina-Elena; Ciocoiu, Manuela; Vladeanu, Maria; Filip, Alexandru; Forna, Norin; Sirbu, Mihnea Theodor; Ungureanu, Carmen; Sîrbu, Paul Dan

doi:10.3390/diagnostics13010013

Cited by 5 publications

(5 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Almost all reported events are provoked VTE due to catheter insertion, clotting factor supplementation with or without surgery, or the use of nonfactor replacement therapies. 139 As the occurrence of acute VTE in PWH is very heterogeneous, a simple recommendation is not feasible. In most cases, removal of the catheter or cessation of the procoagulant therapy will be sufficient and no additional antithrombotic therapy is needed in patients with severe hemophilia.…”

Section: Clinical Question 12: Can Systemic Thrombolysis Be Given In ...mentioning

confidence: 99%

“…The occurrence of an acute VTE in PWH is a rare event. Almost all reported events are provoked VTE due to catheter insertion, clotting factor supplementation with or without surgery, or the use of nonfactor replacement therapies 139 . As the occurrence of acute VTE in PWH is very heterogeneous, a simple recommendation is not feasible.…”

Section: Section 5: Venous Thromboembolismmentioning

confidence: 99%

See 1 more Smart Citation

Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance

et al. 2023

View full text Add to dashboard Cite

Cardiovascular disease is an emerging medical issue in patients with hemophilia (PWH) and its prevalence is increasing up to 15% in PWH in the United States. Atrial fibrillation, acute and chronic coronary syndromes, venous thromboembolism, and cerebral thrombosis are frequent thrombotic or prothrombotic situations, which require a careful approach to fine-tune the delicate balance between thrombosis and hemostasis in PWH when using both procoagulant and anticoagulant treatments. Generally, PWH could be considered as being naturally anticoagulated when clotting factors are <20 IU/dL, but specific recommendations in patients with very low levels according to the different clinical situations are lacking and mainly based on the anecdotal series. For PWH with baseline clotting factor levels >20 IU/dL in need for any form of antithrombotic therapy, usually treatment without additional clotting factor prophylaxis could be used, but careful monitoring for bleeding is recommended. For antiplatelet treatment, this threshold could be lower with single-antiplatelet agent, but again factor level should be at least 20 IU/dL for dual antiplatelet treatment. In this complex growing scenario, the European Hematology Association in collaboration with the International Society on Thrombosis and Haemostasis, the European Association for Hemophilia and Allied Disorders, the European Stroke Organization, and a representative of the European Society of Cardiology Working Group on Thrombosis has produced this current guidance document to provide clinical practice recommendations for health care providers who care for PWH.

show abstract

Section: Clinical Question 12: Can Systemic Thrombolysis Be Given In ...mentioning

confidence: 99%

Section: Section 5: Venous Thromboembolismmentioning

confidence: 99%

Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Thrombosis has recently been described with novel non-replacement drugs [ 96 ]. Thrombosis can be a complication of major surgery in the case of intensive replacement therapy [ 97 ]. Cancer itself can promote thrombosis, which can add the risk of surgery or an indwelling catheter.…”

Section: Resultsmentioning

confidence: 99%

Haemophilia and Cancer: A Literature Review

Zanon,

Porreca,

Simioni

2024

JCM

View full text Add to dashboard Cite

Background: Opinions in the literature on the impact of cancer on patients with haemophilia are contradictory. There is a lack of data on the clinical presentation and management of cancer in patients with haemophilia (PWH). Methods: Papers were found following a comprehensive search in PubMed, Google Scholar, and Scopus using the terms “cancer” and “haemophilia” without time limits and using the English language as a filter. The references from all the retrieved original articles and reviews were assessed for additional relevant articles. Results: The emergence of malignancies is one of the important causes of morbidity and mortality in PWH. In the past decade, the literature mainly focused on the epidemiology and outcome of blood-borne cancers in the haemophilia patient group, as the incidence of hepatitis B virus (HBV), hepatitis C (HCV), and HIV infection were high among them. However, with the introduction of recombinant clotting factor concentrates (CFCs), physicians now pay attention to non-virus-related malignancies. Bleeding and thrombotic complications are important causes of morbidity and mortality in critically ill patients with cancer; replacement therapy with factor VIII or IX or others should be maintained during antitumour treatment. Conclusion: Overall, managing cancer in patients with haemophilia requires careful evaluation and individualised planning involving a multidisciplinary team of physicians experienced in haematology, oncology, and surgery.

show abstract

“…Thrombosis has recently been described with novel non-replacement drugs [115]. Thrombosis can be a complication of major surgery in the case of intensive replacement therapy [116]. Cancer itself can promote thrombosis, which can add the risk of surgery or an indwelling catheter.…”

Section: Haemophilia and Cancer And Cardiovascular And Thrombotic Riskmentioning

confidence: 99%

Haemophilia and Cancer: A Systematic Review

Zanon,

Porreca,

Simioni

2024

Preprint

View full text Add to dashboard Cite

Background: Opinions on the impact of cancer on patients with haemophilia literature are contradicting. There is a lack of data on the clinical presentation and management of cancer in patients with haemophilia (PWH). Methods: Papers were found following a comprehensive search in PubMed, Google Scholar, and Scopus using the terms “cancer” and “haemophilia” without time limits and using the English language as a filter. The references of all retrieved original articles and reviews were assessed for additional relevant articles. Results: Overall, 116 papers were collected. Managing cancer in patients with congenital bleeding disorders, such as haemophilia A and B, requires careful evaluation of bleeding risk and the effect of antitumor treatments on blood coagulation. Generally, patients with haemophilia do not have an increased risk of developing cancer compared to the general population; increased risk is found in the presence of HIV or hepatitis infection. However, if a patient with haemophilia develops cancer, the treatment must be managed to minimise the risk of bleeding. Bleeding and thrombotic complications are important causes of morbidity and mortality in critically ill patients with cancer; replacement therapy with factor VIII or IX or others should be maintained during antitumor treatment. Conclusion: Overall, managing cancer in patients with haemophilia requires careful evaluation and individualised planning involving a multidisciplinary team of physicians experienced in haematology, oncology, and surgery.

show abstract

Thromboembolic Disease in Haemophilic Patients Undergoing Major Orthopaedic Surgery: Is Thromboprophylaxis Mandatory?

Cited by 5 publications

References 55 publications

Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance

Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance

Haemophilia and Cancer: A Literature Review

Haemophilia and Cancer: A Systematic Review

Contact Info

Product

Resources

About