Thromboembolic Events During Combination Chemotherapy for Germ Cell Malignancy

Cantwell, B. M. J.; Mannix, Kathryn; Roberts, J.T.; Ghani, Sarah; Harris, Adrian L.

doi:10.1016/s0140-6736(88)90113-4

Cited by 55 publications

(42 citation statements)

References 5 publications

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“…Two previous studies also underscored the apparent high risk of TEE in GCT patients receiving chemotherapy, although there was no control group in these studies (Cantwell et al, 1988;Weijl et al, 2000). In a series of 52 patients, Cantwell et al (1988) reported 10 TEE (19%), including seven venous events, three arterial events, and one death. In another series of 179 patients, Weijl et al (2000) reported 15 TEE (8%), including 13 venous events, two arterial events, and one death.…”

Section: Discussionmentioning

confidence: 96%

“…In a British series of 333 patients with advanced GCT, the incidence of vena cava compression was 9.3%, of whom 29% had a thrombo-embolic complication and one patient died of pulmonary embolism (Hassan et al, 1999). Two previous studies also underscored the apparent high risk of TEE in GCT patients receiving chemotherapy, although there was no control group in these studies (Cantwell et al, 1988;Weijl et al, 2000). In a series of 52 patients, Cantwell et al (1988) reported 10 TEE (19%), including seven venous events, three arterial events, and one death.…”

Section: Discussionmentioning

confidence: 98%

“…However, only a few studies have specifically focused on this subject (Cantwell et al, 1988;Weijl et al, 2000). It was originally described by Trousseau that patients with cancer are at increased risk for venous TEE, although the mechanisms are not fully elucidated (Trousseau, 1865).…”

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confidence: 99%

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The risk of thrombo-embolic events is increased in patients with germ-cell tumours and can be predicted by serum lactate dehydrogenase and body surface area

et al. 2005

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The aim of this study was to evaluate the risk of thrombo-embolic events (TEE) in patients with germ-cell tumours (GCT) who receive cisplatin-based chemotherapy, to compare this risk to that of a matched control group of non-GCT cancer patients, and to identify risk factors of TEE. The rate of TEE during the 6 months following the initiation of chemotherapy was assessed in 100 consecutive patients with GCT and in 100 controls with various neoplasms who were matched on sex and age, and who received first-line cisplatin-based chemotherapy during the same period of time at Institut Gustave Roussy, Villejuif, France. Data were subsequently tested on a validation group of 77 GCT patients treated in Lyon, France. A total of 19 patients (19%) (95% confidence interval (CI): 13 -28) and six patients (6%) (95% CI: 3 -13) had a TEE in the GCT group and the non-GCT control group, respectively (relative risk (RR): 3.4; Po0.01). Three patients from the GCT group died of pulmonary embolism. In multivariate analysis, two factors had independent predictive value for TEE: a high body surface area (41.9 m 2 ) (RR: 5 (1.8 -13.9)) and an elevated serum lactate dehydrogenase (LDH) (RR: 6.4 (2.3 -18.2)). Patients with no risk factor (n ¼ 26) and those with at least one risk factor (n ¼ 71) had a probability of having a TEE of 4% (95% CI: 1 -19) and 26% (95% CI: 17 -37), respectively. In the GCT validation set, 10 (13%) patients had a TEE; patients with no risk factor and those with at least one risk factor had a probability of having a TEE of 0 and 17% (95% CI: 10 -29), respectively. Patients with GCT are at a higher risk for TEE than patients with non-GCT cancer while on cisplatin-based chemotherapy. This risk can be accurately predicted by serum LDH and body surface area. This predictive index may help to study prospectively the impact of thromboprophylaxis in GCT patients.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

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The risk of thrombo-embolic events is increased in patients with germ-cell tumours and can be predicted by serum lactate dehydrogenase and body surface area

et al. 2005

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“…[2][3][4] However, there are only a few reports of venous thrombosis without such vascular compression.…”

Section: Discussionmentioning

confidence: 99%

Disappearance of a major thrombus in the brachiocephalic vein without anticoagulant therapy in a patient with seminoma - a case report

Hongo

Ide

Hoshino

et al. 2013

CUAJ

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This is the first case report describing brachiocephalic vein thrombosis without compression by a metastatic tumour during chemotherapy for testicular cancer. According to previous reports of testicular cancer patients with a major thrombus, anticoagulant therapy was required to resolve all cases. However, in the present case, a major thrombus in the brachiocephalic vein disappeared without anticoagulant therapy. This 42-year-old man was diagnosed with testicular seminoma and multiple metastases to the para-aortic lymph nodes. After 3 cycles of cisplatin, etoposide and bleomycin (PEB) therapy, a major thrombus in the right brachiocephalic vein was recognized on a computed tomography (CT) scan. Although no anticoagulant therapy was undertaken, the thrombus in the right brachiocephalic vein was no longer visible on CT after the fourth cycle of PEB therapy.

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“…Various casereports have been supportive, and larger studies have attempted to summarize the incidence of these events [11]. In a cohort of 179 males who received cisplatin-based chemotherapy for GCT, 15 (8.4%) developed TEE, of which 3 (17%) were arterial [10].…”

Section: Discussionmentioning

confidence: 99%

Arterial thrombosis after cisplatin-based chemotherapy for metastatic germ cell tumors

et al. 2009

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Thromboembolic Events During Combination Chemotherapy for Germ Cell Malignancy

Cited by 55 publications

References 5 publications

The risk of thrombo-embolic events is increased in patients with germ-cell tumours and can be predicted by serum lactate dehydrogenase and body surface area

The risk of thrombo-embolic events is increased in patients with germ-cell tumours and can be predicted by serum lactate dehydrogenase and body surface area

Disappearance of a major thrombus in the brachiocephalic vein without anticoagulant therapy in a patient with seminoma - a case report

Arterial thrombosis after cisplatin-based chemotherapy for metastatic germ cell tumors

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